JOURNAL TRANSCRIPT
WINTER 2018
THE
CRISPR REVOLUTION
Northwestern Medicine scientists usher in a new era of genetic research • 16
INSIDE A REMARKABLE YEAR • 10
ONCOLOGY CLOSE-UP • 20
FULL SPECTRUM OF GYNECOLOGIC CARE • 24
PRECISION PATHOLOGIST • 28
FIRST GLANCE
Northwestern Medicine Community Spotlight
A Lighter Side of Medical School JAMMING AT IN VIVO
Northwestern Medicine magazine is published quarterly for alumni and friends of Northwestern University Feinberg School of Medicine, Northwestern Memorial HealthCare and the McGaw Medical Center of Northwestern University.
John Flaherty, MD, professor of Medicine in the Division of Infectious Diseases, jams with second-year medical student Nick Volpe in a performance by “The Hypochondriacs” during the 39th annual production of In Vivo, Feinberg’s popular sketch comedy and variety show.
Editorial Advisors: Eric G. Neilson, MD, vice president for Medical Affairs and Lewis Landsberg Dean; Alan Krensky, MD, vice dean for Development and Alumni Relations; Nicole Mladic, executive director of Communications; Babette Nyka, director of Alumni Relations
Editor: Nora Dunne
Alumni Association: James P. Kelly, ’73 MD, President; Rishi Reddy, ’00 MD, President-elect
Editorial Assistant: Yesenia Navarro
Design: Taylor Design
Contributing Writers: Amber Bemis, Will Doss, Marla Paul, Cheryl SooHoo, Anna Williams
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[email protected] ©2017 Northwestern University. Northwestern Medicine® is a federally registered trademark of Northwestern Memorial HealthCare and is used by Northwestern University. Material in Northwestern Medicine magazine may not be reproduced without prior consent and proper credit.
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Address all correspondence to: Northwestern University, Feinberg School of Medicine, Office of Communications 420 E. Superior Street, Rubloff 12th Floor Chicago, IL 60611 PHOTOG R APHY BY Randy Belice
Winter 2018
NORTHWESTERN M EDICIN E MAGA ZIN E
CONTENTS
Features
10
16
A REMARKABLE YEAR
THE CRISPR REVOLUTION
Reflecting on the medical school’s
Northwestern Medicine scientists usher
accomplishments in 2017.
in a new era of genetic research.
20
24
ONCOLOGY CLOSE-UP
28
FULL SPECTRUM OF GYNECOLOGIC CARE
PRECISION PATHOLOGIST
the Lurie Cancer Center at the forefront
New clinical programs provide collaborative,
in the field of pathology.
of its field.
cutting-edge care for women of all ages.
Discover a program and a leader putting
Daniel Brat is spearheading transformations
Departments LEADERSHIP
PULSE
ALUMNI
WARD ROUNDS®
02 Looking Forward in 2018
03 On Campus New Simpson Querrey Center
31 Alumni President’s Message 32 Alumni Profile
41 Artifacts From Special Collections
for Epigenetics, Exploring a
Mummy’s Secrets
34 Campaign Update 35 Progress Notes 40 Perspective
06 Research Briefs 08 Media Spotlight 09 Faculty Awards & Honors
Ora Hirsch Pescovitz, ’79 MD
W illiam Weber, ’17 MD, ’17 MPH
ON THE COVER CRISPR-Cas RNA silencing complex. Computer model shows a max protein (green) bound to a strand of DNA (pink). Max, a member of the basic helix-loop-helix leucine zipper family of transcription factors, is involved in cell proliferation, differentiation and apoptosis. Transcription factors are proteins that bind to specific sequences of DNA and control the transcription of genetic information from DNA to RNA. (Laguna Design/Science Source)
MAGA ZIN E . N M .ORG
1
LEADERSHIP
Looking Forward in 2018
Eric G. Neilson, MD
Dean M. Harrison
E
VERY TREATMENT EVER OFFERED TO A PATIENT was once an experiment in a lab, fueled by years of scientific effort. As we reflect on our successes in 2017 and plan for what is to come in 2018, it’s important to acknowledge our commitment to developing the treatments that will become tomorrow’s cures and to providing the most advanced healthcare to our patients. This reminds us of our purpose as we close one year and begin anew. At Feinberg, we have made great strides to deliver on the promise of our mission to improve human health through education and discovery. Our students and trainees arrived on campus this year with extraordinary backgrounds (the new MD Class of 2021, for example, had median GPA and MCAT scores in the 98th percentile), and our graduates left with even more ambition and passion than when they came. These achievements are thanks to the exceptional faculty mentors in our educational programs and our innovative curriculum that emphasize flipped classrooms, team-based learning exercises, simulation, patient communication and student research. We are more confident than ever that our graduates are prepared to reshape the field of medicine. Our research enterprise, too, continues to reach new heights. In the last year, our scientists published 238 papers in highprofile journals and funding grew more than 6 percent, confirming the prestige and impact our investigators have in their fields.
2
NORTHWESTERN M EDICIN E • WINTER 2018
Construction of the Louis A. Simpson and Kimberly K. Querrey Biomedical Research Center is on track and will soon provide the space to grow our research enterprise even more. In this issue of Northwestern Medicine magazine, we highlight many of the ways we are solidifying our place in emerging research areas: Our new Simpson Querrey Center for Epigenetics will investigate how environmental conditions impact the human genome. Our OncoSET program combines oncology with genomic sequencing to offer cutting-edge cancer care personalized to individual patients, while our new chair of Pathology leads national efforts to incorporate molecular findings into brain tumor diagnoses. And our cover story describes how many of Feinberg’s laboratories are using innovative CRISPR-Cas9 gene editing techniques to better understand human disease and improve therapies. The health system also enjoyed another successful year: Northwestern Memorial Hospital was ranked the top hospital in Chicago and Illinois for the sixth straight year and No. 13 nationally by U.S. News & World Report. We made improvements in physician and staff engagement and continued to report strong financial performance. We expanded the Bluhm Cardiovascular Institute to two Northwestern Medicine hospitals (bringing the total to four hospital locations), opened two new gynecology programs at Northwestern Memorial Hospital and expanded the Advanced Lung Disease Clinic to the northern suburbs. We also introduced the first combined MRI-PET machine to Chicago and began performing innovative new procedures, including implanting a novel device to manage advanced heart failure and another to give men with enlarged prostates a minimally invasive treatment option. Looking forward, this spring we will be activating our system-wide electronic health record and opening the new Northwestern Medicine Lake Forest Hospital. These efforts are more examples
98 th percentile CLASS OF 2021’S MEDIAN GPA AND MCAT SCORES
238 PAPERS BY NORTHWESTERN MEDICINE SCIENTISTS PUBLISHED IN HIGH-PROFILE JOURNALS
6% INCREASE IN RESEARCH FUNDING
#1 and #13 NORTHWESTERN MEMORIAL HOSPITAL RANKING IN CHICAGO AND ILLINOIS (#1) AND IN THE COUNTRY (#13)
of our Patients First mission and our relentless drive to be better. It is worth taking stock of the remarkable things we have accomplished this past year — it inspires us to take on new challenges, feeds future discovery and forges stronger connections with our students, patients, mentees and collaborators. Our best wishes to all in the new year!
With warm regards, Eric G. Neilson, MD Vice President for Medical Affairs Lewis Landsberg Dean Dean M. Harrison President and CEO Northwestern Memorial Healthcare
PULSE
ON CAMPUS
New Epigenetics Center to Study Role of Environment on Genes $10 MILLION GIFT CREATES SIMPSON QUERREY CENTER FOR EPIGENETICS
Chromatin forms when DNA (orange) wraps tightly around histone proteins (purple).
A new $10 million gift from University trustees and supporters Louis A. Simpson and Kimberly
“At Northwestern, leading scientists are coming together to study not just the body but also the way the environment and our decisions affect our health.”
K. Querrey will create a center at Feinberg to study the effects of environment on the activation and expression of genes.
The new Simpson Querrey Center for
Epigenetics will investigate how environmental factors such as emotional experiences, chemical exposure, obesity, exercise, diet and
This year, Shilatifard’s laboratory and his
drug therapies can modify genes packaged in
biology, fundamental biology, epidemiology
human chromatin, causing them to become
and clinical medicine to develop foundational
collaborators published several groundbreak-
insights about how environmental conditions
ing discoveries reporting the development of
impact the human genome using sophisticated
epigenetic targeted therapeutics for childhood
molecular, biochemical and computational
leukemia, childhood brain cancer and adult
methods.
triple negative breast cancer. One study on
KEY DEFINITIONS
Epigenetics: the study of heritable
changes caused by modification of gene expression rather than alteration of the underlying DNA sequence that makes up genes
Chromatin: a complex of DNA and proteins that packages and protects DNA and controls gene expression and DNA replication
“Epigenetic-driven insights are proving
fundamental to a myriad of diseases including
childhood brain tumors led to a phase I clinical trial planned for this year at the Ann & Robert H.
cancer, heart, immunologic and neurological
Lurie Children’s Hospital of Chicago.
conditions,” said Eric G. Neilson, MD, vice
president for Medical Affairs and Lewis
requires creativity and collaboration,”
Landsberg Dean. “Understanding the details of how individual genes, groups of genes and environmental factors work together to deter-
“Solving the world’s biggest problems
Querrey said. “At Northwestern, leading scientists
mine the human condition is at the forefront
are coming together
of medicine today.”
to study not just the
more or less receptive to new biochemical
signals. Epigenetic modifications of chromatin
PhD, the Robert Francis Furchgott Professor
the environment and
can have a direct effect on the regulation of
of Biochemistry and Pediatrics and chair
our decisions affect
gene expression. Some of this regulation is
of Biochemistry and Molecular Genetics.
our health. Lou and
good, and some of it causes disease.
Shilatifard’s work focuses on understanding
I are thrilled to be a
the intricate chromatin mechanisms that
part of this ground-
regulate gene expression.
breaking work.”
The center brings together experts in bio-
chemistry, molecular genetics, computational
IMAG E Gunilla Elam/Science Source
The center will be led by Ali Shilatifard,
body but also the way
UPDATE The generous new gift from Simpson and Querrey brings their total giving to Northwestern to $164 million. See page 34 for a full update on We Will. The Campaign for Northwestern.
MAGA ZIN E . N M .ORG
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PULSE
On Campus
The mummy was prepared 1,900 years ago in Egypt and excavated in 1911. A recent CT scan confirmed she was a 5-year-old girl.
Exploring a Mummy’s Secrets Scientists peered inside an ancient mummy using CT scans and synchrotron X-rays to learn about bone strength over time.
WRIT TEN BY Will Doss
USING THE BRIGHTEST X-RAY SOURCE IN
THE WESTERN HEMISPHERE, Northwestern
The Roman-Egyptian mummy resides at
the Garrett-Evangelical Theological Seminary
different directions. The angles at which the
Medicine scientists directed a narrow beam
on Northwestern’s Evanston campus. A cura-
X-rays diffract and the intensities of the differ-
of high-energy X-rays through an ancient
tor at Northwestern’s Block Museum of Art
ent diffracted beams reveal information about
mummy, aiming to reveal secrets about
stumbled upon it while investigating materials
the object’s structure, according to Stock.
within these nanocrystals scatter X-rays in
ancient Egyptian bone nanostructure that
for an exhibit this winter.
could help modern medicine better predict
intensities of these diffracted beams, then you
who might be at risk of fracture.
out disturbing the delicate portrait and wrap-
can identify what material it is — it’s like a fin-
pings, the curators contacted Stock to arrange
gerprint,” Stock said. “As far as I know, no one
Led by Stuart Stock, PhD, research
Wanting to discover what was inside with-
“If you know the angles and relative
professor of Cell and Molecular Biology, the
a CT scan at Northwestern Memorial Hospital.
has tried to non-invasively interrogate what’s
team used the Advanced Photon Source at
Stock agreed to perform the scan, but wanted
inside an object like this.”
Argonne National Laboratory this November
to go further: take the mummy to Argonne
to explore the structure of the mineral
National Laboratory to analyze bone nano-
petence, a measure of bone strength which
Stock was most interested in bone com-
constituents of the mummy’s bones without
structure using synchrotron X-ray diffraction.
becomes critical in osteoporosis.
disturbing the mummy’s wrappings.
Bone contains a high density of nanocrys-
tals and the periodic arrangement of atoms 4
NORTHWESTERN M EDICIN E • WINTER 2018
The most significant determinant of bone
competence is mineral density — the more
PHOTOG R APHY BY Jim Prisching and Northwestern University
On Campus
1
“W E’RE BASICALLY ABLE TO GO BACK TO AN EXCAVATION THAT HAPPENED MORE THAN 100 YEARS AGO AND RECONSTRUCT IT WITH OUR CONTEMPORARY ANALYSIS TECHNIQUES.”
The mummy underwent a CT scan at Northwestern Memorial Hospital in August.
mineral you have in your bones, the more
modern sedentary populations — is there a
they resist fracture. However, some older
difference in bone quality?”
the brain cavity are likely solidified pitch, not
individuals who have fractures also have
bones with high mineral density. According to
the mummy’s bones with that of the bones of
also investigating a scarab-shaped object,
Stock, some of this unexpected fracture risk
modern-day humans may quantify the bene-
her teeth and what look like wires near the
is explained by poorly structured trabecular
fits of an active lifestyle, improving clinicians’
mummy’s head and feet.”
ability to predict who is at risk for a fracture
bone — the porous bone present at the ends of
Comparing the mineral nanostructure of
“We have confirmed that the shards in
a crystalline material,” Stock said. “We are
The findings from the synchrotron
experiment, CT scan and other analyses
long bones — but that does not account for the
and enhancing preventative care.
whole discrepancy. Instead, it may be that the
quality of the bone tissue varies.
at bone density and trabecular bone structure
understand the life and death of this Roman
and maybe predict fracture risk correctly
mummy, according to Marc Walton, research
“AS FAR AS I KNOW, NO ONE HAS TRIED TO NON-INVASIVELY INTERROGATE WHAT’S INSIDE AN OBJECT LIKE THIS.”
“Right now in osteoporosis, we can look
will help investigators and historians better
80 percent of the time,” Stock said. “We need
professor of materials science and engineer-
to improve our predictive ability to around
ing at the McCormick School of Engineering.
95 percent, so we’ve got to track down addi-
tional factors.”
cavation that happened more than 100 years
ago and reconstruct it with our contemporary
In addition to bone composition, Stock
“We’re basically able to go back to an ex-
and colleagues will use X-ray diffraction
analysis techniques,” Walton said. “All the
say peak muscle mass and bone mass are pro-
patterns to identify other objects within the
information we find will help us enrich the
“There are epidemiological studies that
tective through life, particularly for women,”
mummy’s wrapping, matching the patterns
entire historic context of this young girl
Stock said. “I wanted to compare populations
measured at Argonne with the patterns of
mummy and the Roman period in Egypt.”
who had an active lifestyle with our more
other materials such as gold or rock.
2
In November, the mummy traveled to Argonne National Laboratory for a synchrotron X-ray experiment.
3
The angles and relative intensities of the diffracted beams revealed information about the body’s structure.
4
Scientists will study the mummy’s bone composition and identify other objects in her wrapping.
MAGA ZIN E . N M .ORG
5
PULSE
More details on these studies at magazine.nm.org
RESEARCH BRIEFS DISE ASE DISCOVE RI ES
STEM CELLS LEAD TO BETTER UNDERSTANDING OF RETINAL DEVELOPMENT
required to repress Rspondin-2 from the anterior part of the head where the eyes are eventually going to form.
“The prospect of using stem cell-based
therapies to treat different types of retinal diseases is becoming a real possibility; therefore, having a better understanding of the cellular and
Northwestern Medicine scien-
Immunostaining of a developing neuroretina (red) surrounding the lens (nuclei in yellow). F-actin-expressing cells are in green.
molecular processes controlling eye morpho-
tists used embryonic stem cells
genesis and neuroretina differentiation is
and induced pluripotent stem
critical,” said principal investigator Guillermo
cells to generate eye organoids
Oliver, PhD, the Thomas D. Spies Professor of
that mimic early eye development, creating a
Lymphatic Metabolism. Nozomu Takata, PhD,
tool that allowed them to characterize molec-
a postdoctoral fellow in Oliver’s lab, was the
ular events that regulate the formation of the
first author.
complex organ. The findings were published in
Cell Reports.
accurately recreate live organs in lab-grown
models, opening up possibilities for future
The scientists focused on the neuroretina,
The study also showed that stem cells can
a collection of eye cells that help convert light
research.
into neural signals, and identified the gene
Rspondin-2 as a critical player in mammalian
culture system as a reliable and fast alternative
neuroretina differentiation.
to identify and evaluate genes involved in eye
The authors found that during early
development, when the eye is initially forming and is still just an outgrowth of neural tissue, the activity of the transcription factor Six3 is
“Our results further validate the organoid
morphogenesis and neuroretina differentiation in vivo,” Oliver said. This work was supported by the National Eye Institute grant EY12162 and a Fellowship for Research Abroad from the Uehara Memorial Foundation.
CLI N ICAL B RE AK TH ROUG HS
Synthetic Cannabis-like Drug Reduces Sleep Apnea A synthetic cannabis-like drug in a pill was safe and effective in treating obstructive sleep apnea in the first large multi-site study of a drug for apnea funded by the National Institutes of Health. There is currently no drug treatment for sleep apnea, a sleep breathing disorder affecting about 30 million individuals in the United States. Untreated apnea raises the risk of heart disease, diabetes, sleepiness, cognitive impairment and a motor vehicle accident. Participants in the Northwestern Medicine and University of Illinois at Chicago trial had reduced apnea and decreased subjective sleepiness, according to the study, published in the journal SLEEP. 6
NORTHWESTERN M EDICIN E • WINTER 2018
The common treatment for sleep apnea is a CPAP (Continuous Positive Airway Pressure) device that delivers air to prevent collapse of the airway and breathing pauses. But adherence to the device can be challenging for many patients, some who simply stop using it. Investigators looked at the effect of dronabinol, a synthetic version of the molecule Delta-9 THC (tetrahydrocannabinol), which is in cannabis, on sleep apnea. The phase 2 trial, with 73 patients over six weeks, was the largest and longest randomized, controlled trial to test a drug treatment for sleep apnea. Dronabinol targets the brain rather than the physical problem of collapsing airways. This reflects the new belief that sleep apnea is not just a physical problem but may be caused
by multiple factors, such as poor regulation of the upper airway muscles by the brain, said co-lead author Phyllis Zee, MD, PhD, the Benjamin and Virginia T. Boshes Professor of Neurology and director of the Northwestern Medicine Sleep Disorders Center. “The CPAP device targets the physical problem but not the cause,” Zee said. “The drug targets the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles. Better understanding of this will help us develop more effective and personalized treatments for sleep apnea.” This research was supported by grant UM1-HL112856 from the National Heart, Lung, and Blood Institute.
Research Briefs
M E DICAL E DUCATION
Comparing Physical Exam Education at U.S. Medical Schools The resources used to teach the physical exam to pre-clerkship medical students vary widely across U.S. medical schools, according to a study published in Academic Medicine. Teaching the physical exam is generally labor-intensive and requires significant human resources, including faculty, as well as standardized and actual patients, noted Toshiko Uchida, MD, Feinberg’s director of Clinical Skills Education and first author of the study. As such, there have been concerns that some medical schools may be providing inadequate physical exam training. In the study, investigators aimed to understand the various resources and
pedagogical approaches that U.S. medical schools employ to teach the physical exam to pre-clerkship students. The Directors of Clinical Skills Courses, a professional organization of clinical skills educators, administered a 49-question survey to all 141 medical schools accredited by the Liaison Committee on Medical Education. “Some schools likely don’t devote enough time or resources to teaching the physical exam in the pre-clerkship years,” Uchida said. “There is also a great need for further research to determine how much time is enough to learn the physical exam, and how best we can deploy our resources so that students begin to master physical exam techniques.”
SCI E NTI F IC ADVANCES
SUICIDE MOLECULES KILL ANY CANCER CELL Small RNA molecules originally developed as a tool to study gene function trigger a mechanism hidden in every cell that forces the cell to commit suicide, reports a Northwestern Medicine study. The RNA suicide molecules can potentially be developed into a novel form of cancer therapy, the study authors said.
Cancer cells treated with the RNA mole-
cules never become resistant to them because they simultaneously eliminate multiple genes that cancer cells need for survival.
Resources and Approaches Study Results
11
author Marcus Peter, PhD, the Tom D. Spies
6
%
MEDIAN HOURS devoted to teaching physical medical exam across all medical schools
30 HOURS OR LESS
“It’s like committing suicide by stabbing
yourself, shooting yourself and jumping off a building all at the same time,” said senior study
59
%
200 HOURS OR MORE
Professor of Cancer Metabolism.
The inability of cancer cells to develop
resistance to the molecules is a first, Peter said. He and his team discovered sequences in the human genome that when converted into small double-stranded RNA molecules trigger what they believe to be an ancient kill switch in cells to prevent cancer. He has been searching for the phantom molecules with this activity for
OF TH E TI M E S P E NT TE ACH I NG TH E P HYS ICAL E X AM
38
3O
%
%
USED STANDARDIZED PATIENTS
USED PEER-TO-PEER PRACTICE
25
%
USED ACTUAL PATIENTS
eight years.
“We think this is how multicellular
organisms eliminated cancer before the development of the adaptive immune system, which is about 500 million years old,” he said. “It could be a fail-safe that forces rogue cells to commit suicide. We believe it is active in every cell protecting us from cancer.”
P R ACTICE TI M E S P E NT WITH ACTUAL PATI E NTS
50
%
OF STUDENTS OBSERVED BY FACULTY
20
%
OF SCHOOLS NEVER HAD FACULTY OBSERVE STUDENTS
This study, which was published in the
journal eLife, and two other Northwestern studies in Oncotarget and Cell Cycle by the Peter group, describe the discovery of the assassin molecules present in multiple human genes and their powerful effect on cancer in mice. This research was funded by grants T32CA070085, T32CA009560, R50CA211271 and R35CA197450 from the National Cancer Institute.
MAGA ZIN E . N M .ORG
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PULSE
MEDIA SPOTLIGHT
Amish Mutation Protects Against Diabetes and May Extend Life Amish people living in a rural part of Indiana have a rare genetic mutation that protects them from Type 2 diabetes and appears to significantly extend their life spans, according to a new study published in Science Advances. The mutation affects a mysterious protein called plasminogen activator inhibitor-1, or PAI-1, that is known primarily for its role in promoting blood clotting.
Douglas Vaughan, MD, chair of Medicine, photo courtesy of Novocure
took a team of 40 investigators to Berne, Indiana, set up testing stations in a recreation center, and spent two days doing extensive tests on 177 members of the community, many of whom arrived by horse and buggy. “Some of the young men we collected blood from
Electric Fields Therapy Shows Promise for Brain Cancer Patients “My patients have been going skiing,” said Roger Stupp, MD, chief of Neuro-oncology in the Department of Neurology and lead author of a study published in JAMA that tested a home-based electrical field treatment known
fainted because they had never had a needle
as tumor-treating fields to help patients with glioblastoma. The treatment, for most, is surprisingly manageable. Doctors place four electrodes on a patient’s shaved scalp, where they’re worn for most of the day. The electrodes create low-intensity electrical fields within the brain that kill dividing cells. “I have a patient who I met here in Chicago who has gone on a safari in Africa twice now,” Stupp said.
Obesity, Poverty Help Explain Higher Diabetes Risk for U.S. Blacks
stick in their life,” said Vaughan. What he and his colleagues discovered was striking. Amish
other risk factors that may be possible to
carriers of the mutation live on average to
change, a U.S. study published in JAMA
age 85, about 10 years longer than their peers.
suggests. “To eliminate the higher rate of
Among the Amish who did not have the muta-
diabetes, everybody needs to have access
tion, the rate of Type 2 diabetes was 7 percent.
to healthy foods, safe spaces for physical
But for carriers of the mutation, the rate was
activity and equal economic opportunity to
zero, despite leading the same lifestyle and
have enough money to afford these things
consuming similar diets.
and live in communities that offer this,” Even though black adults are more likely to develop diabetes than white adults, the increased risk is largely due to obesity and
8
NORTHWESTERN M EDICIN E • WINTER 2018
said lead author Michael Bancks, PhD, a postdoctoral fellow in Preventive Medicine at Feinberg.
FACULTY AWARDS & HONORS
1
Mary McDermott, MD, ’92 GME, the Jeremiah Stamler Professor of Medicine in the Division of General Internal Medicine and Geriatrics and of Preventive Medicine, was named a Distinguished Scientist by the American Heart Association. The award honors prominent scientists and clinicians who have made significant contributions to the understanding of cardiovascular disease and stroke. McDermott has dedicated her research to lower extremity peripheral artery disease (PAD); her many accomplishments include demonstrating that supervised treadmill exercise improves walking ability among people with PAD, even when they are asymptomatic or have atypical leg symptoms. McDermott will also lead a new research network center sponsored
2
by the AHA focused on calf muscle pathology and disability in PAD. 1 Laimonis Laimins, PhD, the Guy and Anne Youmans Professor and chair of MicrobiologyImmunology, and Richard J. Miller, PhD, the Alfred Newton Richards Professor of Pharmacology, were named Fellows of the American Association for the Advancement of Science. Laimins was recognized for his contributions to the field of viral oncology, particularly for his studies on the differentiation-dependent life cycle of human papillomaviruses. Miller was recognized for his contributions to neuroscience and neuropharmacology, particularly in elucidating the role ion channels and receptors play in synaptic communication in health and disease. 2, 3
3
Firas Wehbe, MD, PhD, assistant professor of Preventive Medicine in the Division of Health and Biomedical Informatics, has been appointed Northwestern Medicine’s inaugural chief research informatics officer. 4 Patricia Garcia, MD, MPH, ’91 GME, professor of Medical Education and Obstetrics and Gynecology in the Division of MaternalFetal Medicine, was named associate dean for curriculum.
4
and Phil Hockberger, PhD, associate professor of Physiology, were named associate vice presidents to Northwestern University’s Office for Research. June McKoy MD, JD, MBA, was chosen to join the National Commission on Orthotic and Prosthetic Education (NCOPE) board of directors. The NCOPE is responsible for setting education standards of all professionals in the field of orthotics/prosthetics. 7
5
Alexis Thompson, MD, MPH, professor of Pediatrics in the Division of Hematology, Oncology, and Stem Cell Transplantation, has been named president of the American Society of Hematology. 6 Richard D’Aquila, MD, the Howard Taylor Ricketts, MD, Professor of Medicine in the Division of Infectious Diseases,
Emily Rogalski, ’07 PhD, was named one of Crain’s Chicago Business’s “40 Under 40.” She was recognized as a disruptor who is “upsetting the status quo” through her groundbreaking work with SuperAgers. William Gradishar, MD, the Betsy Bramsen Professorship of Breast Oncology and interim chief of Hematology and Oncology in the
5
Department of Medicine, was among the top 27 breast oncologists in the country based on data from Grand Rounds, a company that uses a machine learning algorithm to analyze publicly available and proprietary data about physicians, as reported by Forbes. Donald Lloyd-Jones, MD, senior associate dean for Clinical and Translational Research and chair of Preventive Medicine, was among the top 27 cardiologists. Amy Paller, MD, the Walter J. Hamlin Professor and chair of Dermatology, was selected by her colleagues in the Women’s Dermatologic Society to receive the 2018 Wilma Bergfeld, MD Visionary & Leadership Award. Peter Penzes, PhD, the Ruth and Evelyn Dunbar Professor of Psychiatry and Behavioral Sciences, was named director of Feinberg’s newly
6
7
announced Center for Autism and Neurodevelopment. The center’s mission is to catalyze scientific collaborations to better understand the biological bases of autism and related neurodevelopmental disorders and to translate those findings into new treatments. H. William Schnaper, MD, the Irene Heinz Given and John LaPorte Given Research Professor of Pediatrics in the Division of Kidney Diseases, received the 2018 American Society of Pediatric Nephrology Founders’ Award, which recognizes individuals who have made a unique and lasting contribution to the field of pediatric nephrology. scientific collaborations to better understand the biological bases of autism and related neurodevelopmental disorders and to translate those findings into new treatments.
MAGA ZIN E . N M .ORG
9
REFLECTING ON OUR
ACCOMPLISHMENTS IN 2017
A REMARKABLE YEAR Record-breaking research activity. A curriculum that better prepares students for clerkships. A new skyscraper takes shape on campus. Read on for some of the top news from the Feinberg School of Medicine in 2017.
HIGH-IMPACT RESEARCH A sampling of the breakthrough findings published by Feinberg-led research teams in the previous year.
Surgical residents across Simple behavioral interventhe country have grown tions can effectively curb accustomed to flexible inappropriate antibiotic duty hour requirements, prescribing, if adopted without rules on maximum for the long term. (Journal shift lengths and time off of the American Medical between shifts, which were Association) previously shown to be safe for patients and better for resident education. (New England Journal of Medicine)
Groundbreaking Molecular Discoveries
RESEARCH Feinberg’s Funding Surpasses $471 Million
S
ponsored research awards secured by principal investigators at the medical school grew to $471.7 million last fiscal year, a 6 percent increase over the previous year. “Feinberg’s remarkable research growth continued last year,
despite overall National Institutes of Health funding staying flat for medical schools as a whole,” said Rex Chisholm, PhD, vice dean for scientific affairs and graduate education.
“We’re proud to say that last year’s funding covered a wide variety
of disease-based science and cross-cutting biomedical themes,” he added. “Our strengths in leveraging big data, reducing health disparities and fundamental science have translated to new techniques and clinical questions that we’re just now beginning to explore.”
$471.7
72
+6
MILLION
PERCENT
PERCENT
The medical school’s sponsored research awards totaled $471.7 million in 2017.
Feinberg generated 72% of all research dollars at Northwestern University.
Sponsored research awards were up six percent in 2017 from 2016.
A new method of analyzing non-coding regions of DNA in neurons may pinpoint which genetic variants are most important to the development of schizophrenia and related disorders. (Cell Stem Cell)
Normal agers lose volume in the cortex, which contains neurons, twice as fast as SuperAgers, a rare group of older people whose memories are as sharp as those decades younger. (Journal of the American Medical Association)
The lab of Ali Shilatifard, PhD, the Robert Francis Furchgott Professor of Biochemistry and Pediatrics and chair of Biochemistry and Molecular Genetics, had a prolific year, publishing papers in journals including Science, Nature Medicine, Cell and Genes and Development. Among the discoveries, the team identified the genetic driver of mixed lineage leukemia and a targeted molecular “This work could not have therapy that halts the been done anywhere proliferation of leukein the world except mic cells. The scientists Northwestern Medicine, also found a molecule because of all the that stops the growth of aggressive pediatric brain scientists and physicians who have been recruited tumor diffuse intrinsic here during the past five pontine glioma, and they years and how they work learned that targeting together to link basic the SET1B protein in the scientific research to the cytoplasm of cells may be clinic.” – Ali Shilatifard able to treat triple-negative breast cancer. Other findings elaborated on scientists’ understanding of gene expression and embryonic stem cell development. Shilatifard will lead Feinberg’s new Simpson Querrey Center for Epigenetics (read more on page 3).
NORMAL AGERS lose volume in the cortex as they age
SUPERAGERS lose volume in the cortex at 1/2 the rate of normal agers
A promising bioactive nanomaterial has the potential to stimulate bone regeneration and improve quality of life for surgical patients and lead to less- invasive procedures. (Nature Nanotechnology)
MAGA ZIN E . N M .ORG
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HIGH-IMPACT RESEARCH con’t The neuronal degeneration Inhibiting the process of in patients with Parkinson’s autophagy — a natural disease was linked to a toxic process of cell destruction cascade beginning with an that also plays a protective accumulation of oxidized role under stress conditions dopamine and the protein — may enhance the effects alpha-synuclein, providof radiation therapy for ing a possible therapeutic glioblastoma. (Cancer Cell) pathway. (Science)
ACADEMICS
The human immuno deficiency virus uses proteins called diaphanousrelated formins to hijack the cytoskeleton of healthy cells. (Proceedings of the National Academy of Sciences)
Number of New Students by Program
Two commonly used drugs, thyroxine and metformin, erased the learning and memory deficits in rat pups caused by fetal alcohol exposure when the drugs were given after birth, potentially identifying a treatment for the disorder. (Molecular Psychiatry)
161
30
Doctor of Medicine Program
Driskill Graduate Program in the Life Sciences
New MD Curriculum Assessed
L
ast fall, Northwestern Medicine
RECORD-BREAKING RESEARCH DAY
faculty described the medical school’s comprehensive curriculum
redesign, rolled out in 2012 with the
graduating class of 2016, and reported early outcomes on student achievement, confidence and engagement in a paper published in Academic Medicine.
Students’ U.S. Medical Licensing
Examination Step 1 and Step 2 scores stayed stable between the old and new curriculums, while student surveys demonstrated that those in the current curriculum felt significantly better prepared in clinical skills before entering clerkships compared to those who went
“We have significantly more clinical immersion now. [Students] see they are making a meaningful difference in patients’ lives, and that’s invigorating.”
through the former curriculum. Further, students reported greater confidence in
otherwise seemed dry,” explained
their professional development.
Heather Heiman, MD, leader of the
“We have significantly more clinical
curriculum’s clinical medicine element.
immersion now, and our students tell us
“[Students] see they are making a mean-
that as a result, when they see patients
ingful difference in patients’ lives, and
they understand the importance of
that’s invigorating.”
More than 400 abstracts showcased the diversity of innovative research taking place at Feinberg. The 13th Annual Lewis Landsberg Research Day last spring included projects on basic science research, clinical research, public health and social sciences research, and education research. Winners of the poster competition focused on areas of research spanning from myofilament components in arrhythmia and dilated cardiomyopathy to longitudinal studies of primary care clerkships and patient outcomes.
basic science content that might have
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NORTHWESTERN M EDICIN E • WINTER 2018
PHOTOG R APH ABOVE LEF T BY Jim Prisching
Kaylin McMahon, ’17 PhD (L) and Doug Wilcox, ’16 PhD (R)
A unique population of immune cells called monocyte-derived alveolar macrophages plays a key role in the development of pulmonary fibrosis; targeting such cells could lead to new treatments for the disease. (The Journal of Experimental Medicine)
Celebrating PhD Students In 2017, Feinberg welcomed 30 new PhD students from as far away as Puerto Rico, Russia and India to the Walter S. and Lucienne Driskill Graduate Program (DPG) in Life Sciences. During the sixth annual Driskill Day last fall, DGP students and faculty received awards for their innovative research and mentorship.
20
15
4
3
1
Northwestern University Interdepartmental Neuroscience Program
Medical Scientist Training Program
Clinical Psychology PhD Program
Health Sciences Integrated PhD Program
Doctor of Physical Therapy/PhD Engineering Program
Among them, Kaylin McMahon, ’17 PhD, was recognized for her work developing bioinspired delivery vehicles for nucleic acid therapies for cancer, while Doug Wilcox, ’16 PhD, an MD/ PhD student in the Medical Scientist Training Program, received an award for his research on the age-dependent mechanisms of pathogenesis in herpes simplex virus encephalitis.
MAGA ZIN E . N M .ORG
13
CAMPUS
Early 2017
Late 2017
Simpson Querrey Biomedical Research Center Nears Completion “This building is a blend of a new construction and stacking on the Robert H. Lurie Medical Research Center. Each floor will be connected to the Lurie facility, and it will be wrapped with a full plaza featuring green space on the outside. The building will also have a sky bridge that connects to the Ward Building.” – Chris Jones, senior superintendent at Power Construction, general contractor of the project
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NORTHWESTERN M EDICIN E • WINTER 2018
O
ver the course of 2017, the Louis A.
Simpson and Kimberly K. Querrey
sity broke ground on the building, extensive
In October, two years after the univer-
Biomedical Research Center progressed
mechanical, electrical, duct and piping work
from an extensive underground construction
was taking place behind the exterior of the
project to a 300-foot tall, 14-story structure.
building by more than 200 skilled trades
workers onsite.
In June, the Northwestern community
gathered to celebrate as a ceremonial steel
beam was set in place atop the Simpson
installing windows on the outside of the
Querrey Biomedical Research Center. The
building and begin connecting a bridge to the
ceremony marked a major milestone in the
Ward Building. The outdoor plaza work will
construction of the 600,000-square-foot
also start to take shape and the interior work
building, which will significantly expand the
on the lab floors will become a main focus.
medical school’s research enterprise.
Over the next year, the team will finish
Sketches from the plans for the new building, designed by architecture firm Perkins+Will.
HONORS Medical School and Hospital Affiliates Rank High
FACULTY RECOGNIZED WITH PRESTIGIOUS AWARDS 1
In 2017, Feinberg maintained its standing among the best
2
research-oriented medical schools in the country, placing 17th in the latest U.S. News & World Report rankings. Meanwhile, the company recognized
3
three Northwestern Medicine hospitals in its 2017–18 rankings of America’s Best Hospitals. The Shirley Ryan AbilityLab once again earned the top spot among rehabilitation hospitals in the country, and Lurie Children’s ranked first among children’s hospitals in Illinois.
4
Many Feinberg faculty were recognized nationally by their peers as leaders in their fields. Among them, Donald Lloyd-Jones, MD, ScM (1), senior associate dean for clinical and translational research and chair of Preventive Medicine, who was named Physician of the Year by the American Heart Association and a member of the Association of American Physicians. Karl Bilimoria, MD, ’08 MS, ’10 GME (2), director of the Northwestern Surgical Outcomes and Quality Improvement Center and the John Benjamin Murphy Professor of Surgery and Medical Social Sciences, and Sarki Abdulkadir, MD, PhD (3), the John T. Grayhack, MD, Professor of Urological Research and professor of Pathology, joined the American Society for Clinical Investigation. Melissa Simon, MD (4), the George H. Gardner Professor of Clinical Gynecology, was appointed to the U.S. Preventive Services Task Force to make evidence-based recommendations for preventive screenings, counseling services and medications.
MAGA ZIN E . N M .ORG
15
CRISPR THE
R E V O LU T I O N Northwestern Medicine scientists usher in a new era of genetic research. Written by Will Doss he McNally lab members were
three years, now would take just four to six
CRISPR AT FEINBERG
shocked.
months, allowing scientists around the world
Using CRISPR to edit the genomes of human
to more quickly understand mechanisms of
cells or model organisms has become a staple
used a new gene editing tech-
disease and more efficiently translate those
of research activities at Feinberg — especially
nique that promised to transform
discoveries from bench to bedside. At Feinberg,
when combined with induced pluripotent
how scientists investigated the
CRISPR gene editing is being used today in
stem cells (IPSCs).
human genome. Prior to that day in late 2014,
many settings, including to isolate mutations
editing genes in mammalian cells had been a
that cause neurological diseases and to run
a human subject, turn those into stem cells
time-consuming process — sometimes requir-
large-scale genetic screens to understand how
and direct the resulting IPSCs to develop into
ing screening hundreds of clones to find one
individual genes can damage — or protect
a specific type of tissue, such as cardiac cells,
with altered DNA — and it often ended in failure.
— cells.
neurons or skeletal muscle tissue. This tech-
But then, Eugene Wyatt, PhD, a postdoctoral
nique helps investigators identify cellular
fellow in the lab, generated a cellular model of
quick to point out that CRISPR-Cas9 is not just a
mechanisms of disease and can be com-
genetic disease in human embryonic kidney
laboratory tool; it also has tremendous potential
bined with CRISPR to isolate disease-causing
cells faster than ever before by harnessing a
for use in patients, though there are still unre-
mutations.
specialized region of DNA called CRISPR.
solved ethical and regulatory issues to think
T
For the first time, they had
Northwestern Medicine scientists are
Scientists can harvest adult cells from
For example, stem cells can be created
through before editing live human genomes.
using genetic material from patients with
showed evidence of editing,” says Elizabeth
But its first experimental use in patients is
amyotrophic lateral sclerosis (ALS), and
McNally, MD, PhD, the Elizabeth J. Ward
closer than most realize, according to McNally.
those cells differentiated into motor neurons.
Professor of Genetic Medicine and director
Investigators can compare those neurons to
of Feinberg’s Center for Genetic Medicine.
told you it will be ten years before somebody
neurons from healthy individuals, looking
“This was truly revolutionary — older methods
injects a patient with a genome-editing virus,”
for genetic mutations in the diseased model.
only worked in very specific cells and relied
McNally says. “Now I think it’s about two or
If they find a suspicious mutation, they can
on waiting for a cell’s natural machinery to
three years away.”
use CRISPR to reverse the genetic muta-
edit genes. With CRISPR, that machinery
tion, creating a stem cell line identical to the
could be directly introduced into the cells,
spinning pace at which CRISPR technology
patients’ cells, but without the mutation —
dramatically improving efficiency.”
is changing genetics. The first peer-reviewed
this is called an isogenic control line.
papers showing successful gene editing in
“More than 80 percent of the clones
Tasks such as creating a mouse model
of disease, which previously took about
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NORTHWESTERN M EDICIN E • WINTER 2018
“If you had asked me last year, I would’ve
That prediction underlines the head-
mammals were published just five years ago.
If you had asked me last year, I would’ve told you it will be ten years before somebody injects a patient with a genome-editing virus. Now I think it’s about two or three years away.
IMAG E Evan Oto/Science Source
MAGA ZIN E . N M .ORG
17
How CRISPR Works
Guide RNA
Just as CRISPR was transforming what scientists can do with cells, it equally changed the landscape for genetically engineering mice to model human diseases. The diagram at right illustrates how the CRISPR-Cas9 gene editing complex works. A sequence of RNA (green) programmed to find a specific segment of DNA (blue) is inserted into a cell along with the Cas9 enzyme (purple). Once the RNA finds the matching DNA, Cas9 cuts it. In that space, a fragment of donor DNA containing new genetic information (red) can be inserted.
Matching genomic sequence
Cas9
Donor DNA
“This allows us to test whether a
phenotype or defect in a motor neuron is caused by that particular mutation,” says
Repair
Evangelos Kiskinis, PhD, assistant professor of Neurology. “If the defect goes away, we’ve established the mutation is necessary for
Targeted genome editing
the defect.”
Kiskinis also uses CRISPR to do the
opposite experiment. He takes a healthy stem cell line, introduces the mutation using CRISPR and asks if that change is sufficient enough to induce the same phenotype.
This method becomes even more
important when looking at diseases caused
Parkinson’s disease is a loss of function in
compound, says Chandel, a member of the
by a combination of genes, such as epilepsy.
dopamine neurons, which are known to be
Robert H. Lurie Comprehensive Cancer Center
Kiskinis and his colleagues have introduced
vulnerable to oxidative stress.
of Northwestern University.
a known epilepsy-causing gene variant into a
variety of stem cell lines derived from healthy
Naturally those dopamine neurons will be the
mystery,” he says. “CRISPR positive-selection
individuals. They’re looking for insights into
most susceptible to damage from the pesti-
screens could be a way to figure it out.”
the impact of an individual’s broader genetic
cide,” says Chandel.
background and why certain people develop
epilepsy and others don’t.
lection screen, creating thousands of cells with
While there’s little legal or ethical debate
one individual gene turned off.
around using CRISPR with cultured cells or
this in human cells,” Kiskinis says. “Before,
non-embryonic stem cells, using the tool to
it was technically possible, but extremely
the majority of them died, but not all. Certain
edit the genome of living humans — especially
challenging; it would take a very long time.”
cells with knocked-out genes were resistant
in a manner where changes would be inher-
to paraquat, suggesting those genes may be
ited by children — is still uncharted territory.
large-scale genetic screens, a fast and simple
responsible for the toxicity. One gene in par-
Scientists in China reported using CRISPR to
way to investigate the effects of individual
ticular, called POR, was pinpointed as the main
edit a gene responsible for a deadly blood dis-
genes in cells. Navdeep Chandel, PhD, the
source of damage-causing oxidation, according
order in non-viable embryos, but few embryos
David W. Cugell, MD, Professor of Medicine,
to Chandel.
survived and it set the international scientific
used this method to narrow down which genes
community off into a fiery debate.
made a person vulnerable to Parkinson’s
dividends in the future, including in the
disease after repeated exposure to an herbi-
development of drugs designed to generate
but rather a question of when CRISPR-like
cide called paraquat.
oxidative stress in cancer cells, killing them
technology will be used in humans, according
“This is the first time we are able to do
Another application of CRISPR is in
“Paraquat generates a lot of oxidants.
His team conducted a CRISPR positive-se-
They then exposed the cells to paraquat —
Investigating oxidant stress could pay
“The biology of oxidative stress is still a
UNANSWERED QUESTIONS
However, it’s no longer a question of if,
while leaving healthy cells alone. While some
to Raj Awatramani, PhD, associate professor
farmers exposed to paraquat have a higher
drugs currently exist, not enough is known
of Neurology in the Division of Movement
risk of Parkinson’s disease. A major cause of
about their pathways to create a functioning
Disorders.
18
Epidemiological studies indicate that
NORTHWESTERN M EDICIN E • WINTER 2018
IMAG E Gunilla Elam/Science Source
Local Beginnings
F Human induced pluripotent stem cells that have been gene edited with CRISPR from the lab of Elizabeth McNally, MD, PhD.
“Society doesn’t keep pace with the
science,” says Awatramani, who uses CRISPR to create model neurons vulnerable to Parkinson’s disease. “We need to have new ethical guidelines to deal with genome editing in humans. Right now, it’s gray, gray and grayer.”
Several companies are racing to be the
first to use CRISPR in living humans, usually to treat serious chronic diseases such as HIV/AIDS or Duchenne muscular dystrophy, according to McNally. For Duchenne, the proposed treatments would involve injecting a patient — probably a young child — with a virus containing CRISPR material. Early models show that even if uptake only occurs in some cells, symptoms are relieved because the corrected cells tend to compensate for the diseased cells.
“It’s nerve-wracking when we’re talking
about children,” says McNally, who testified about the importance of using this method to treat genetic disease to the U.S. House of Representatives Committee on Science, Space and Technology in 2015. “Diseases like Duchenne muscular dystrophy are so difficult for patients and their families that it could be argued trying the therapy is the right thing to do, as long as it’s reasonably safe.”
Regardless of its future as a therapeutic
tool, CRISPR has entrenched itself as a central mechanism for genetics research, in an astonishingly short period of time. Combined with the adaptability of IPSC, the technologies have irrevocably changed genetics for the better.
“There’s no question, when people look
back 100 years from now, they’ll find it hard to believe all of this was discovered at the same time,” McNally says. “This is truly a revolutionary time for genetics.”
irst discovered by Francisco Mojica in Spain in 1993, CRISPR is made up of short, repeated sequences of DNA and non-coding spacer DNA. Its purpose confounded investigators. But by 2003, Mojica had identified thousands of sequences of genetic code in CRISPR that matched snippets of bacterial and viral genomes. He hypothesized that CRISPR was part of an adaptive immune system that copies sequences from invading microbes to ward off viral infections of bacteria. Scientists around the world recognized CRISPR’s potential as an experimental tool and set out to investigate it further. Northwestern University was the setting of important research establishing the basic science behind CRISPR. In 2008, Luciano Marraffini, PhD, a postdoctoral fellow in the lab of Erik Sontheimer, PhD, then an associate professor of Biochemistry, Molecular Biology and Cell Biology at Northwestern’s Weinberg College of Arts and Sciences, became the first to empirically prove CRISPR destroys plasmid or virus DNA molecules directly and to suggest that it can be programmed to target any DNA. They published their findings in a landmark paper in Science. “Our work was a breakthrough in the understanding of CRISPR, since it explained how it works at the molecular level,” says Marraffini. Sontheimer adds, “Most important of all, we were the first to recognize and explicitly articulate the possibility that CRISPR could be repurposed for genomic engineering.” The pair filed a patent declaring CRISPR could be used to manipulate the genomes of complex organisms, but the patent was denied, citing lack of experimental demonstration. By then, other investigators had linked the CRISPR system with Cas9, an enzyme that modifies DNA, and begun to harness the whole complex for genome editing. The final breakthrough happened in January 2013, when five groups from around the world published We were the first to independent studies within three recognize and explicitly weeks showing the system could articulate the possibility be programmed to target specific points of DNA in mammalian cells. that CRISPR could be Among them were scienrepurposed for genomic tists from the Massachusetts Institute of Technology, who engineering. collaborated with Marraffini, then at The Rockefeller University, to publish a paper in Science demonstrating that the CRISPR sequence can be transcribed into short RNA sequences that drag Cas9 to a specific locus and cut the DNA, turning the targeted gene off. This discovery rocked the field of genetics: Just nine months after the initial Science publication, an additional 1,500 articles on the CRISPR-Cas9 complex had been published, refining and improving the tool. This was made possible by the decision to make CRISPR reagents readily available online with instructions to help scientists design the right experimental tools, says McNally.
MAGA ZIN E . N M .ORG
19
Oncology Discover a program and a leader putting the Lurie Cancer Center at the forefront of its field.
CURATED CANCER CARE Physicians and scientists in OncoSET are teaming up to help pioneer precision oncology.
U
ntil recently, treatment for patients with
cancer generally followed a broad-brush,
By all rights, I shouldn’t be alive, much less up and at it
“I am the beneficiary of research, pure and simple.
one-size-fits-all approach. Today, it is rec-
every day,” says Maniscalco, a year and a half after his
ognized that each cancer — just like each patient
diagnosis. “The team of people who are caring for me
— is unique.
at the Lurie Cancer Center are fabulous, but it is the
research that led to targeted treatments that is the key
Armed with the understanding that
distinct genetic mutations and abnormali-
to my life.”
ties are at the root of every patient’s cancer,
physicians and scientists now aim to usher in
premise of OncoSET, the flagship clinical and research
an era where treatment is truly tailored to the
program at the Lurie Cancer Center. First launched
individual. The hope is that providing thera-
in 2015, OncoSET is the Lurie Cancer Center’s entry
pies targeted to the specific genetic drivers of
into the emerging movement of precision medicine.
cancer will reduce the toxic side effects seen
Through an innovative three-step process — Sequence,
in less precise treatments and offer patients
Evaluate, Treat — the clinic couples oncology with
improved outcomes overall.
genomic sequencing to offer cutting-edge cancer care
personalized to each patient.
Such is the case with Chuck Maniscalco.
This is the potential of precision oncology, and the
In the fall of 2016, Maniscalco, a retired Chicago
business executive in his 60s, was diagnosed with
says Amir Behdad, MD, assistant professor of Pathology,
Stage IV lung cancer — a disease his mother
director of Cancer Molecular Diagnostics and co-direc-
and younger sister both died of years earlier.
tor of OncoSET’s Molecular Tumor Board. “If we can
attack only a target that’s unique to a patient’s tumor
In the past, his treatment options would
“This is really the most advanced form of oncology,”
typically have been limited to standard chemo-
cells — as opposed to globally attacking the body with
therapy. But after receiving genetic testing at the
chemotherapy — that’s a really attractive option.”
Robert H. Lurie Comprehensive Cancer Center
of Northwestern University, Maniscalco learned
become possible thanks to advances in genetic tech-
he had a mutation in the epidermal growth factor
nology. Next-generation sequencing has now enabled
receptor (EGFR), which can fuel cancer growth.
scientists to obtain a robust understanding of the
As a result, he was a candidate for Tarceva (erlo-
genetic profile of tumors, which had previously repre-
tinib), an oral medication that specifically targets
sented a significant challenge. With more knowledge of
the activity of the EGFR protein.
the molecular makeup of tumors, therapies designed
This strategy, Behdad notes, has only recently
“I am the beneficiary of research, pure and simple. By all rights, I shouldn’t be alive, much less up and at it every day. The team of people who are caring for me at the Lurie Cancer Center are fabulous, but it is the research that led to targeted treatments that is the key to my life.” CHUCK MANISCALCO Lung cancer survivor
The OncoSET Process Through an innovative three-step process, the Lurie Cancer Center’s flagship clinical and research program offers cutting-edge cancer care personalized to each patient.
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NORTHWESTERN M EDICIN E • WINTER 2018
STEP 1: SEQUENCE
STEP 2: EVALUATE
STEP 3: TREAT
profile the tumor
evaluate the results
treat with targeted therapies
WRIT TEN BY Anna Williams
Close-up Top left and bottom right: Lurie Cancer Center members look for circulating tumor cells isolated from liquid biopsies; they hope to find mutations in the cells that will inform diagnosis and treatment for specific cancer patients. Top right: Massimo Cristofanilli, MD, director of OncoSET. Bottom left: Cancer leaders at the inaugural OncoSET Symposium last spring.
to target specific tumor markers have since
extensive genomic data, OncoSET informs
collaborations with commercial partners for
followed.
ongoing discovery of targeted cancer drugs
genetic testing, OncoSET leverages next-gener-
and helps advance pre-clinical research at
ation genomic sequencing to pinpoint changes
and technology are driving big changes in the
Feinberg and around the world.
in specific genes and produce a comprehensive
way we treat cancer, and as the leading cancer
profile of a patient’s tumors. (OncoSET is cur-
center in Chicago, we thought we should offer
we wanted to accomplish very quickly,” says
rently focused on analyzing solid tumors, but
precision medicine to our patients first,” says
Massimo Cristofanilli, MD, director of OncoSET
will soon also evaluate hematologic malignan-
Leonidas Platanias, MD, PhD, director of the
and associate director for Translational Research
cies, such as lymphoma and leukemia.)
Lurie Cancer Center. “I believe very strongly
at the Lurie Cancer Center. “One, of course, was
that this is the way medicine will be practiced
to be more precise in treatment planning for
— and one of only a few in the country — where
10 years from now.”
patients and establish the clinical service. But at
it doesn’t matter where the tumor is located.
the same time, we also wanted to advance trans-
What matters now is the composition of the
“We created OncoSET because science
“There were a couple of major goals
“We’ve created the first clinic in Chicago
A CLINICAL PROGRAM, INFORMING TOMORROW’S CURES
lation and feed our research purpose.”
tumor and the patient’s genomic analysis,”
explains Platanias, who is also the Jesse, Sara,
In addition to helping individual patients,
a simple blood draw from a patient for a
Andrew, Abigail, Benjamin and Elizabeth Lurie
there’s another, broader, benefit to the
liquid biopsy (in some cases, a traditional
Professor of Oncology.
OncoSET model: By collecting and analyzing
tissue biopsy is available as well). Through
PHOTOG R APHY BY Laura Brown
The OncoSET process begins with
MAGA ZIN E . N M .ORG
21
Every week, OncoSET’s Molecular Tumor
With that mission in mind, OncoSET
Board gathers to analyze the sequencing
hosted its inaugural symposium last spring,
results of individual patients, one by one.
sharing significant advances in precision
During this evaluation stage, it’s all hands
oncology with healthcare professionals from
on deck: The multidisciplinary team, co-di-
across the country and discussing strategies
rected by Cristofanilli and Behdad, is made up
for translating new discoveries into clinical
of medical, surgical and radiation oncologists,
practice. The Second Annual Lurie Cancer
along with pathologists, molecular scientists,
Center OncoSET Symposium: Practical
pharmacologists, radiologists, genetic counsel-
Applications of Precision Medicine will be
ors, bioinformaticians and other experts across
held May 17, 2018.
a range of specialties.
a prospective registry study — now totaling
In OncoSET, patients are also enrolled in
A DOCTOR AT HEART Deputy Director Maha Hussain oversees clinical research, but never forgets her primary goal: having an impact on patients.
the team devises an optimal treatment plan
more than 400 entries — which provides a
T
for each patient. That treatment, based on the
rich database for basic scientists investigat-
molecularly defined targets, might include an
ing particular mutations. The team is actively
clap with one hand.”
available drug or enrollment in an early-stage
working on developing retrospective analy-
clinical trial being conducted at Northwestern.
ses of treatment outcomes.
Informed by the tumor’s unique profile,
Since its inception, the
“We coordinate our data
Molecular Tumor Board has
with other institutions all
evaluated the genetic pro-
over the country. Eventually,
files of hundreds of patients, many of whom had advanced stage cancer or cancer that was unresponsive to standard treatment. Not only has the model made a real difference in individual patient outcomes, but with basic scientists at the table, new insights gleaned through the clinic may eventually serve as the building blocks of tomorrow’s targeted cures.
“After doing these gene
profiles and analyses of
“Eventually, after enough information has accumulated, there will be a tipping point — really a drastic change — in the way we practice oncology.” LEONIDAS PLATANIAS, MD, PHD Director of the Lurie Cancer Center
after enough information has accumulated, there will be a tipping point — really a drastic change — in the way we practice oncology,” says Platanias, also a professor of Medicine in the Division of Hematology and Oncology, and of Biochemistry and Molecular Genetics.
This new approach to
oncology is still at an experimental stage, of course, and the OncoSET team notes that as science and technology in
patients, we can bring all that information back to the lab,” Platanias explains.
this area rapidly evolve, so will the process of
“We can try to better understand some of the
providing precision cancer care. The program
abnormalities we detect — we still don’t know
is currently centered on genomics and molec-
the importance of many — conduct more
ular diagnostics, but in the future new tools
studies, develop new drugs and, eventually,
like epigenetic analysis, proteomic analysis
bring them back to the clinic.”
and metabolomics may also help match patients with the individualized treatment
PIONEERING A FUTURE OF PRECISION ONCOLOGY
plan that might benefit them most.
OncoSET has also emerged as a national
the more we will be bringing it back to
leader in advocating for a precision medicine
OncoSET to optimize our analysis,” Platanias
approach to cancer care and research.
adds. “We think this is the future, and we are
moving fast.”
“One important focus for this program
“The more we understand in science,
is educating physicians on the value of this model,” says Cristofanilli, also a professor of Medicine in the Division of Hematology and Oncology. “We want to be on the forefront in demonstrating its utility.”
22
NORTHWESTERN M EDICIN E • WINTER 2018
here’s an old Iraqi proverb that has stuck with Maha Hussain, MD, since she left her native country: “You can’t For Hussain, deputy director of the
Robert H. Lurie Comprehensive Cancer Center of Northwestern University, it’s an idea at the core of her approach to personal and professional success.
“It takes a team,” Hussain says.
“Throughout my career, I have been successful in part because of collaboration with other people — whether it was colleagues I worked with or the support of my husband and family.”
Hussain, who joined Northwestern in
September 2016, is an internationally recognized authority on clinical research and a leading expert in genitourinary oncology, especially prostate and bladder cancer. She is also an active clinical investigator focused on novel therapeutics and a practicing oncologist at Northwestern.
“In some ways, I wear many hats.
But deep down, I’m a doctor at heart,” says Hussain, also the Genevieve E. Teuton Professor of Medicine in the Division of Hematology and Oncology. “I didn’t get into this just to sit in an office all day. Everything I do, even while in an administrative job, needs to have a direct or indirect impact on patients.”
As part of that mission, some of
Hussain’s chief responsibilities at the Lurie Cancer Center are enhancing clinical trial infrastructure, expanding clinical trial protocols, facilitating scientific translation and forging partnerships that grow clinical research opportunities for cancer patients.
To refer a patient or request a consultation, email
[email protected] or call 312-472-1234.
“At Northwestern, we all provide
exceptional care. But I always say that exceptional care will never be good enough if we don’t have a cure or impactful
“There is an incredible willingness here to work together to impact patient outcomes through science, research, mentorship and excellence in medical care.”
in the mid-1980s. It was an exciting era, she says, with many discoveries, clinical trials and investments being made in research. Cures were becoming possible, such as in testicular cancer, and cancer was no longer automatically “a death sentence.” But while caring for patients in a local VA hospital, Hussain was also deeply discouraged by the lack of progress in prostate cancer. “It was just so awful to see men coming in with horrible disease, and you had really hardly anything to do for them,” Hussain says. “To me,
MAHA HUSSAIN, MD Deputy Director of the Lurie Cancer Center
it was a turning moment — I realized this is an area where there’s a clear need for impact. And I felt an urgent need to contribute.”
A FULL CAREER In her career since then, Hussain’s research and leadership have helped improve standards of care for metastatic hormone-sensitive and castration-resistant prostate cancer. She has authored close to 250 scientific publications and book chapters and taken leadership roles in a variety of national oncology committees. Amidst that work, she has continued to care for patients as a clinician and serve as a teacher and mentor. She has also put a priority on outside interests — her family, including a son and daughter, and hobbies such as travel, reading, photography, cooking and a robust treatments for our patients,” Hussain says.
Hussain and her husband, also a physician, left
“That’s why my passion is research. Research
to pursue their residency training abroad, just
is what will cure cancer.”
as the Iraq-Iran war was breaking out. After
was recruited to the University of Michigan,
social life. After her time at Wayne State, Hussain
three years in England, they landed in Detroit,
where she spent almost 14 years in top scien-
FROM BAGHDAD TO DETROIT
where a few of Hussain’s family members had
tific and leadership positions before joining
As far back as she can remember, Hussain has
already immigrated.
Northwestern.
always wanted to become a physician. Growing
The couple planned to return to Iraq after
“I was ready to take on the adventure of
up in Baghdad, her family encouraged her to
completing their training. “But there was one
working with a new team, with the wonderful
pursue her goals. “I never thought that because
war there after another, and we elected to stay,”
brain trust at Northwestern, in order to develop
I was a woman I shouldn’t be a doctor,” she says.
Hussain says. “It was the best decision we have
the best possible clinical research for our
“It was a very open culture, where education
ever made. Baghdad is our motherland, but the
patients,” Hussain says. “There is an incredible
and performance was the great equalizer.”
U.S. is our home.”
willingness here to work together to impact
After graduating from the prestigious Baghdad University College of Medicine in 1980,
Hussain was first drawn to oncology
patient outcomes through science, research,
during her residency at Wayne State University
mentorship and excellence in medical care.”
IRAQ
ENGLAND
U.S.
WAYNE STATE
MICHIGAN
NORTHWESTERN
Graduates from medical school
Begins residency training
Continues residency, starts medical career
Begins prostate cancer research and treatment
Attains numerous scientific and leadership positions
Joins Feinberg as deputy director of Lurie Cancer Center
Journey to Northwestern Medicine Hussain’s arrival at Northwestern Medicine spanned three countries and two universities.
PHOTOGRAPHY BY Andre LaCour
MAGA ZIN E . N M .ORG
23
FULL SPECTRUM OF GYNECOLOGIC CARE
New clinical programs provide collaborative, cutting-edge care for women of all ages.
“I AM A VERY HAPPY PATIENT,” says Umang Singh of Lake Forest, Illinois. In summer 2003, after trying to start a family with no luck and seeing several doctors, Singh, then in her 30s, sought help from Magdy Milad, MD, MS, chief of Gynecology and Gynecologic Surgery at Northwestern Memorial Hospital. He found the cause of her infertility: advanced endometriosis. After undergoing small-incision laparoscopic surgery, Singh became pregnant five months later. Fast forward 13 years. In summer 2016, Singh, now a
WRIT TEN BY Cheryl SooHoo • ILLUSTR ATED BY Chris Gash
mother of three, began experiencing heavy uterine bleeding to the point of developing anemia. Her endometriosis had seemingly “returned with a vengeance.” She was told by a gynecologist that a radical hysterectomy and early menopause were in her immediate future, but didn’t believe that was her best option. Neither did Milad. That November, he performed a minimally invasive procedure that quickly alleviated Singh’s problem. From puberty to menopause, women like Singh keep their reproductive systems
healthy with annual checkups and general gynecologic care from their regular gynecologists and primary care physicians. But when routine care becomes something more challenging, obtaining specialized gynecological expertise for complex conditions can frequently result in a disjointed endeavor for patients and physicians alike. Many women must seek answers to their “female” problems on their own, going from one specialist referral to another to find care that best addresses their needs — until now.
MAGA ZIN E . N M .ORG
25
n July,
or tubal disease. While all very
Northwestern
common problems of the female
Medicine launched
reproductive system, they
the Center for
can sometimes become, well,
Comprehensive
complicated.
Gynecology (CCG)
at Northwestern Memorial
“We provide highly inte-
grated specialized care that
Hospital, with Milad as its
frequently goes beyond the
medical director. Featuring a
purview of the general obste-
one-of-a-kind multidisciplinary
trician/gynecologist,” explains
approach, the new center offers
Milad, who is also the Albert
women a unique one-stop shop
B. Gerbie, MD, Professor of
for highly specialized care for
Obstetrics and Gynecology and
complex gynecological disorders
chief of Minimally Invasive
and diseases. Housed in the Northwestern Medicine Lavin Family Pavilion, the center inte-
Gynecologic Surgery at Feinberg. “Many women with fibroids or in menopause, for example,
grates the expertise of minimally
receive wonderful care from
invasive gynecologic surgeons,
their regular doctors. But if a
interventional radiologists, phys-
woman has fibroids so large they
iatrists, physical therapists, psy-
are affecting fertility or severe
chologists and others. All working
menopausal symptoms that
together as a team in one place
are disrupting their lives, we
and space, these experts deliver
can help.”
collaborative leading-edge care
that is patient-centered rather
of the CCG is a particularly
than procedure-focused.
distinguishing feature, especially
“Our mission is to treat
The collaborative approach
in the case of fibroid treatment.
women across the spectrum of
Noncancerous uterine tumors,
their lives with leading-edge tech-
fibroids can cause a host of
nology and the latest therapies,”
symptoms from heavy menstrual
interventional radiologists and
says Serdar Bulun, MD, the chair
bleeding to pelvic pressure
gynecologists in one location to
and John J. Sciarra Professor of
and pain. Treatment strategies
jointly see patients.
Obstetrics and Gynecology. “Our
range from gynecologic surgery
approach is agnostic across the
(open and minimally invasive) to
Milad of this rare partnership.
specialties. It’s not a matter of
remove them and/or the uterus,
medical therapy versus surgery
to minimally-invasive interven-
versus an interventional radiol-
tional radiology procedures such
“Our mission is to treat women across the spectrum of their lives with leading-edge technology and the latest therapies.”
“It’s unheard of,” says
“Working physically side by side allows us to offer patients the best treatment strategy for their particular situation and provide
ogy procedure. Our goal is to
as uterine fibroid embolization
provide the best treatment and
(UFE) to shrink them. The
follow-up for each and every
options, though, are provided
patient.”
by different physicians: the
UN-COMPLICATING THE COMPLEX
latter, interventional radiologists.
pioneers in the relatively young
Typically, the two specialty areas
field, Northwestern Medicine’s
Every day, experienced phy-
work in separate silos, forcing
interventional radiology team is
sicians care for women with
patients to do the legwork.
a national leader in this innova-
fibroids, endometriosis, ovarian
Northwestern Medicine’s
tive, nonsurgical alternative to
cysts, uterine abnormalities
CCG may be the first to unite
hysterectomy.
former, gynecologists and the
26
NORTHWESTERN M EDICIN E • WINTER 2018
thorough follow-up as a team.”
UFE has only been avail-
able in the United States since the mid-1990s. One of the early
their doctor doesn’t know there
refer patients out to other spe-
are clinical experts with solu-
cialists, we bring experts from
tions to their problems,” says
dermatology, urogynecology and
Lauren Streicher, MD, ’83 GME,
other disciplines to the center to
medical director of a recently
see our patients.”
established Northwestern
Medicine clinical center focused
the CCG and CSMM provide
on filling this void in the care of
fertile ground at Northwestern
women.
Medicine for research and
medical training efforts focused
In October, the new Center
on complex gynecologic prob-
for Sexual Medicine and Menopause (CSMM) opened its
lems. In obstetrics and gyne-
doors. Sharing space and staff
cology, fellowships in minimally
with the CCG, the CSMM brings
invasive gynecologic surgery are
together a multidisciplinary team
among the most competitive in
of physicians, advanced practice Lauren Streicher, MD, ’83 GME, medical director of the Center for Sexual Medicine and Menopause works with state-ofthe-art technology, including a medical CO2 laser that stimulates vulvar and vaginal tissue to restore lubrication and elasticity.
Along with clinical care,
nurses, certified sex therapists and pelvic floor physical therapists. Comprised of three major areas of expertise, the center offers clinical programs in sexual medicine, menopause and vulvovaginal disorders. In addition to providing a broad array of both
“Unlike other programs that make the diagnosis and then refer patients out to other specialists, we bring experts to the center to see our patients.”
the discipline across the country. For every one position, there are more than 60 applicants. Says Milad, “There’s a tremendous need for training gynecologists in complex surgical procedures.”
At the CSMM, opportuni-
ties will also abound for further educating not only physicians
hormonal and non-hormonal
in training and those currently
treatment options, the clinic also
practicing, but also patients
features state-of-the-art technol-
themselves, according to
ogy such as the Mona Lisa Touch,
Streicher.
a medical CO2 laser that stimu-
lates vulvar and vaginal tissue to
intercourse and intimacy and
restore lubrication and elasticity.
even non-sexual hormonal issues
“Problems with sexual
SEXUAL HEALTH REVOLUTION
Many major academic
are somewhat taboo topics in the
Embarrassment prevents
medical centers provide some
doctor-patient relationship,” she says. “Increasing awareness will
many women from bringing up
level of sexual medicine or
difficulties with sex — from lack
menopause services, espe-
help to start the conversation
of desire to painful intercourse
cially for patients with specific
among women and let them
illnesses like cancer. The CSMM
know that help is readily avail-
mated 40 percent of women of all
not only addresses the impact
able, and they don’t have to just
ages have physical, medical, hor-
of other illness, such as diabe-
accept their situations for the
monal or emotional issues that
tes and heart disease, but also
rest of their lives.”
can interfere with intercourse
utilizes a collaborative approach
and intimacy.
that sets it apart.
— with their doctors. Yet an esti-
“Sexual medicine as well
as menopause are two unmet
“Sexual health and hor-
monal issues touch almost every
elements of women’s health that
medical specialty,” says Streicher,
often go unaddressed either
an clinical associate professor
because the patient is reluctant to discuss symptoms with their physician or the patient and/or
PHOTOG R APHY BY Laura Brown
of Obstetrics and Gynecology. “Unlike other programs that make the diagnosis and then
1: The Center for Comprehensive Gynecology (CCG) team, from left to right: Susan Tsai, MD, Angela Chaudhari, MD, Magdy Milad, MD, MS, and Patricia Handler, MSN. 2: Milad, medical director of the CCG, is chief of Gynecology and Gynecologic Surgery at Northwestern Memorial Hospital. 3: The two centers share space and staff in the Northwestern Memorial Lavin Family Pavilion.
MAGA ZIN E . N M .ORG
27
T
hough pathologists usually work behind the
the tumors into three distinct subtypes associated with a
scenes in laboratories, rather than face-to-face
tumor’s behavior and prognosis. These results, published
with patients, their role in clinical care is crucial.
“It’s estimated that about three-fourths of the
data in the electronic medical record is laboratory
in the New England Journal of Medicine, suggested that genetic status is a more accurate and consistent indicator of a tumor’s classification than the relatively subjective
data and at least two-thirds of clinical decisions are
process of histologic evaluation.
influenced by laboratory results,” says Daniel Brat, MD,
PhD, Feinberg’s new chair of Pathology.
that has been critical in our field,” Brat says. “We are
Pathology is also a field that’s rapidly evolving,
in parallel with advances in precision medicine and
“That study, among others, started a transformation
now incorporating molecular findings into our primary diagnoses — making them definitional, rather than an
a trend toward sub-specialization. Brat, a neuropa-
association. That was a big step for us.”
thologist who has spent nearly two decades studying
diffuse gliomas, is spearheading this evolution within
updated its international reference guide for classifying
the arena of brain tumor diagnostics while straddling
central nervous system tumors, outlining for the first
In 2016, the World Health Organization (WHO)
PRECISION PATHOLOGIST Written by Nora Dunne Photography by Teresa Crawford
the line between scientific investigation and the
time molecular parameters for defining tumors. Brat was
practice of medicine.
a heavily involved co-author.
“As the stewards of biospecimens, as well as the
“The WHO doesn’t want to incorporate test results
laboratory results and basic science findings that
into their diagnoses that the vast majority of the world
are derived from them, pathologists are in a prime
doesn’t have the tools or expertise to actually perform,”
position to advance understanding of human disease
he says. “However, it got to the point where we felt we
over the long term, while also supporting clinical
were doing patients a disservice by not incorporating
care on a daily basis,” Brat says.
molecular alterations into primary diagnoses — we knew too much about the different behaviors of specific molec-
FROM HISTOLOGY TO GENOMIC ANALYSIS
For more than a century, pathologists have diagnosed
tic and testing guidelines through the College of American
ular subtypes of brain tumors.” Brat is now leading national efforts to devise diagnos-
most diseases by looking at tissue samples under a
Pathologists. He also travels the country spreading the
microscope. By assessing the appearance and behav-
word about these new findings, delivering presentations
ior of brain tumor cells, neuropathologists have clas-
to hospital leadership and teaching continuing medical
sified and graded gliomas to help clinicians determine
education courses to practitioners.
the best treatment plans for their patients. In 2015,
Brat led a study conducted by a team of more than 300
oncologists and neurosurgeons are reading
“Pathologists, neuro-oncologists, radiation
scientists from 44 institutions worldwide challenging
scientific papers and seeing reams of
that status quo.
molecular profiles on hundreds of
The investigators, part of the Cancer Genome
Atlas Research Network, analyzed the genetic makeup of samples from 293 adults with a lower-grade glioma, a broad and clinically unpredictable class of brain
brain tumor patients with tens of thousands of markers being clustered by computer algorithms,” he says. “They need guidance on what practical
tumor. Looking at molecular markers like mutations
clinical tests to perform to make
and gene deletions, the scientists were able to divide
these diagnoses.”
28
NORTHWESTERN M EDICIN E • WINTER 2018
Daniel Brat is spearheading transformations in the field of pathology.
MAGA ZIN E . N M .ORG
29
Classifying brain tumors is a theme
Brat earned his medical degree and
that has marked Brat’s career since his early
a PhD in biomedical sciences from Mayo
leader, Brat plans to grow the department’s residency program, add four new fellowships —
days as a fellow, when he first described a
Medical School in 1994 and then completed his
in gynecologic pathology, molecular pathology,
rare tumor now known as chordoid glioma.
residency and a fellowship at Johns Hopkins
transfusion medicine and microbiology — and
Over time it was accepted as a new entity
Hospital. After training, he accepted a faculty
continue recruiting and developing the faculty.
by the WHO and found to have a specific
position at Emory School of Medicine, where
genetic signature.
he remained for 17 years until joining Feinberg
talented. I’d like to shine a light on their suc-
“It’s been extremely satisfying seeing my
findings get implemented broadly and improv-
“Our faculty is extremely dedicated and
last September.
cesses, so they are more visible nationally and
internationally,” he says.
“Northwestern is a phenomenal institu-
ing clinical care worldwide. The whole process
tion, and I thought the pathology department,
is eye-opening and a bit addictive,” he admits.
with the right resources and leadership, could
experimental side of pathology. The depart-
Brat is also a strong proponent of the
become one of the nation’s best,” he says. “In
ment has a collection of investigators focused
expert in his field.
addition, the brain tumor group here has had a
primarily on mechanisms of inflammation, epi-
really exceptional rise, both in the Chicago area
thelial biology and cancer. In his own National
and nationally, and I was thrilled to become a
Institutes of Health-funded basic science lab,
James, PhD, professor of Neurological Surgery
part of that.”
Brat investigates the mechanisms that cause
and a collaborator of Brat’s. “His research
is at the forefront of the individualized
grew up in Minneapolis, Brat was also drawn
medicine movement for tailoring cancer
to Northwestern and Chicago for personal
genetic alterations of cancer is to understand
treatments to the unique characteristics of
reasons: His father, Paul Brat, ’63 MD, earned
how these influence biological behavior, so
individual tumors.”
his medical degree here, and his mother cur-
that we can devise better treatments,” he says.
That thirst for discovery has made Brat an “Dr. Brat is a recognized leader, both
nationally and internationally,” says C. David
diffuse gliomas to progress.
Though he was born in Detroit, and
“The next stage after characterizing
“Right now, a clinical study that demonstrates
rently lives in the city’s suburbs.
a two- or three-month increase in life expec-
THE MANY SIDES OF PATHOLOGY
tancy for a patient with glioblastoma will get
Broadly, the practice of pathology can be split
published in a very high profile journal. Big
into two branches: Anatomic pathologists
picture, that’s still a dismal prognosis. We’ve
examine biopsy and surgical resection
1
2
“The next stage after characterizing genetic alterations of cancer is to understand how these influence biological behavior, so that we can devise better treatments.”
got a lot more work to do.”
specimens and make
diagnoses based on
necrosis (cell death) and hypoxia (low oxygen)
what they see under the
trigger rapid progression of glioma. In another,
microscope in tandem with
Brat’s lab uses drosophila (fruit flies) — a
immunohistochemistry,
simplified genetic model — to study a gene
molecular analysis and
that leads to brain tumor growth when deleted.
other tests. Meanwhile,
“BRAT” for short.
manage the laboratories
that provide test results
favorite sports teams — picking up more every
that help guide patient
time he moves — goes to movies and plays, and listens to classical music.
the kinds of samples or diseases examined.
from work, which is a little bit danger-
“There’s been an explosion of informa-
tion about disease that didn’t exist 30 years
“But right now, I live four blocks away
ous, because I do love my job,” he says. “Pathologists really enjoy what they do, from
ago,” Brat says. “With cancer, for instance, it
providing expert diagnoses, to long days in
would be very difficult to be a generalist today
the lab, to teaching the next generation of
with expertise in breast cancer, leukemia and
pathologists.”
lymphoma and brain tumor sub-classifications. It’s just too much information for a single mortal to carry.”
Feinberg’s Department of Pathology cur-
rently consists of 14 specialties, six main areas of research and nearly 100 faculty. As their
NORTHWESTERN M EDICIN E • WINTER 2018
For fun outside of work, Brat watches his
subspecialties within these branches, based on
30
Ironically, that gene is called “brain tumor,” or
clinical pathologists
care. There are also many
3
In one project, his team is exploring how
1: Cheryl Olson, laboratory manager, and Subhas Mukherjee, PhD, research assistant professor of Pathology, with Brat in his lab. | 2: Samples of brain tumor tissue in the “gross room” at Northwestern Memorial Hospital. | 3: Qinwen Mao, MD, PhD, associate professor of Pathology, and Alexa Derayunan, surgical pathology technologist, examine the samples with Brat to make a diagnosis.
LE ARN MORE ABOUT B R AT ’S RES E ARCH AT MAGA ZIN E . N M .ORG
ALUMNI
Alumni President’s Message
Alumni showed off their pride for Feinberg at tailgates and a board member reception last fall.
‘CATSMD’ Ideals A letter from Jim Kelly, ’73 MD
I
n my initial talk with our Medical Alumni Association
average debt of a Feinberg medical school graduate
Board (MAAB) last spring, I expanded the acronym
being $169,000, we’ve never been more aware of the
“MCATS” penned by Bruce Scharschmidt, ’70 MD,
former president of the MAAB, to “CATSMD.” Here I will explain the meaning of this new acronym.
need to support our Feinberg students. M MATTERS Northwestern and Feinberg should matter to all of us. While clearly the trajectory of the
C CULTURE We want the MAAB to encourage a culture
medical school is on the rise locally and nationally,
of commitment and giving back to Feinberg students,
Feinberg graduates should share some personal
graduates and GMEs. Each of us can give back in our own
responsibility to help catalyze change and positively
way: some by being home sponsors through our HOST
affect this moment in medicine. We encourage
program for fourth-year students, some by serving on the
participation and being a part of the evolving change
board, others by contributing to the Nathan Smith Davis
going on in medicine today.
Society or mentoring medical students and HPMEs about the journey ahead.
D DEDICATION We provide programming, services and opportunities dedicated to the ideals of Feinberg,
A ALIGNMENT To be successful, our board policies
professionalism and impacting the medical school
need to align with the priorities of the Feinberg adminis-
through scholarship, life-long learning and giving
tration and you, our alumni constituents. We expanded
back to the institution that links us all.
our Women in Medicine program with a tea and panel discussion at Alumni Weekend last year and will continue that program this year. We also started an MDs in Business seminar series with a successful inaugural event this fall. Aligning in this way, we amplify the MAAB’s message with
So many in our alumni base already work hard to move the “CATSMD” goals forward. Thank you for your hard work and generosity! Together we’re making a real difference at our medical school.
help from our full-time support staff. T TALENT In 2016, the MAAB recognized that we needed greater diversity on our board with respect to ethnic background, age and geography. We also needed a mechanism in place to have current Feinberg student leaders on the MAAB. Both of these priorities have been accomplished. We recruited 20 new MAAB members over the past two years and upgraded the geography, diversity and age of the board simultaneously. We also worked with the Student Senate to make their president a member of the MAAB. We like where we are in early 2018, but we have the mechanisms in place to adopt and change if we need to. S SUPPORT We help our students by encouraging scholarship support from individual classes as well as contributions from individuals and families. We have united around the concept of a tuition-free medical school. With the
MAGA ZIN E . N M .ORG
31
ALUMNI
Profile
Ora Hirsch Pescovitz, ’79 MD
Setting the
FOUNDATION O
WRIT TEN BY Amber Bemis
ra Hirsch Pescovitz, ’79 MD, credits her academic career at Northwestern University for laying the groundwork for her multifaceted career, including in her latest position as president of Oakland University in Rochester, Michigan. “I acquired many important skills during medical school — I became a more careful listener, more passionate and compassionate and more attentive to scientific data — all imperative throughout my entire medical career and now in my new role,” Pescovitz says. Along with playing a critical role in her career, Northwestern is the setting of many fond memories throughout Pescovitz’s life. She met her late husband, Mark Pescovitz, ’78 MD, on the first day of orientation week; she drank her very first cup of coffee during an overnight shift as a medical student worker at the Chicago Tribune; and she has watched her daughter Naomi Pescovitz, ’09 in journalism, her brother
32
NORTHWESTERN M EDICIN E • WINTER 2018
Profile
PESCOVITZ’S CAREER EVOLUTION 1979
1981
1988
2009
2014
2017
Graduated Northwestern with MD
Finished pediatric residency at Children’s Hospital National Medical Center and studied endocrinology at the National Institutes of Health
Started 21-year tenure at Indiana University
Became first female executive vice president for medical affairs at the University of Michigan
Became senior vice president and U.S. medical leader for Eli Lilly
Became president of Oakland University in Rochester, Michigan
Started residency at the University of Minnesota
Emmet Hirsch, ’88 MD, ’92 GME, sister-in-law Arica Hirsch, ’91 MD, ’92 GME, and other family members graduate from Northwestern. Needless to say, Pescovitz has a lot of Northwestern pride. Pescovitz began her academic career at Northwestern in the Honors Program in Medical Education (HPME), a cohort-style program where undergraduates complete a bachelor’s and medical degree in six years. “I loved being in the HPME,” she says. “Our class had a very collaborative spirit. We all thought about the well-being of our patients but also the well-being of each other, and many of us are still close even 40 years later.” In 1974, the HPME was considered progressive for the number of women who were a part of the program. Of the 60 students enrolled, 12 were women. “Some of my lifelong passions and leadership roles started in medical school. I was encouraged by faculty Arthur Veis and Jack Snarr to get involved in student activities such as the Organization of Student Representatives — this really sparked my love for university administration and played an enormous role in my student life and my long-term career,” Pescovitz says. After medical school, she and Mark married and both accepted residency positions at the University of Minnesota. Two years later they moved to Washington D.C., where she finished her pediatric residency at the Children’s Hospital 1 National Medical Center and then went on to study endocrinology at the National Institutes for Health. Following their time in Washington, D.C., the couple settled at Indiana University where she worked as an associate professor of pediatrics and he as a transplant surgeon. During her 21-year tenure at Indiana, Pescovitz rose through the ranks and held many leadership roles including executive
associate dean for research affairs, president and CEO of Riley Hospital for Children and interim vice president for research administration. She is also an accomplished investigator. Her work focuses on the physiologic and molecular mechanisms responsible for puberty 2 and growth disorders, with an emphasis on developing novel therapies for these conditions. Although she has published more than 190 research publications, she describes the moments in her career where she brought people together to collaborate as her proudest accomplishments. “While I was the dean of research, I was the PI on a $155 million grant called the Indiana Genomics Initiative — this was the largest grant the university had ever received — and it was my job to organize the faculty who would be conducting the work,” Pescovitz says. “This is what I am best at: inspiring others to do their finest work and bringing them together. I think this stems from my time at Northwestern where I saw collaboration succeed for the common good.” In 2009, she was recruited as the first female executive vice president for medical affairs at the University of Michigan, where she was in charge of collaboration and activities between the academic health system’s hospitals and health centers and its medical school. There she managed three hospitals, more than 120 health centers and clinics and the University of Michigan Medical School, and oversaw $3.3 billion in revenue and $490 million in research funding. During the winter of 2010, Pescovitz’s husband Mark was killed in a tragic car accident. “When this happened I had to think hard about how I wanted to spend the rest of my career,” she says.
“Our class had a very collaborative spirit. We all thought about the well-being of our patients but also the well-being of each other, and many of us are still close even 40 years later.”
After finishing her contract at Michigan in 2014, Pescovitz took a short sabbatical before being recruited to work at pharmaceutical company Eli Lilly in Indianapolis as the senior vice president and U.S. medical leader. There she focused on learning about the process of drug discovery. Knowing that her heart was in academia, in July 2017 Pescovitz 3 accepted a position at Oakland University, where she plans to focus on increasing research and the University’s strategic growth plan. As president, she PRESIDENTIAL plans to follow the lifelong PRINCIPLES leadership principles she (THE 8 Cs) calls her “8 Cs,” many Moral compass of which she says stem Compassion from ideas formed at Courage Northwestern. Contribution “My vision is to unlock Commitment the potential of individuals Communication and leave a lasting impact through the transformative Collaboration power of education and Creativity research,” she says.
Above: 1 Pescovitz celebrates graduation from medical school at Northwestern. 2 Lewis Landsberg, MD, former dean of the medical school, presents Pescovitz with the 2004 Distinguished Alumni Award. 3 Pescovitz reconnects with Melani Shaum, ’80 MD, during Alumni Weekend in 2015. MAGA ZIN E . N M .ORG
33
ALUMNI
Giving Resources are still needed to create a tuition-free medical school, endow the efforts of our talented faculty, and support our innovative research and teaching programs.
Campaign Update The generosity of thousands of alumni, faculty and friends is helping us impact the health of humankind.
CAMPAIGN FOR NORTHWESTERN MEDICINE
$ 1.72
billion
SCHOLARSHIPS
$ 170 million
98%
21.3%
$1.72 billion raised of $1.75 billion goal
of $800 million goal raised for a tuition-free medical school
FACULTY CAMPAIGN
$3
million 100%
of Feinberg department chairs contributed
CAMPAIGN PRIORITIES
The cost of medical school
With the partnership of new and longtime
and living in Chicago are
shape my life and career as
benefactors, we are raising crucial funds to:
honestly tremendous.
an academic physician.
• Build out ten core institutes that bring together patient care, research, education, community service and advocacy • Build the new Louis A. Simpson and Kimberly K. Querrey Biomedical Research Center • Construct a centerpiece hospital and medical office facilities at Northwestern Medicine Lake Forest Hospital • Create endowed professorships that accelerate the efforts of our most accomplished and promising faculty physicians and scientists • Establish endowed and expendable innovation grants for breakthrough research • Create scholarships for our exceptional medical, PhD and physical therapy students, and nurses • Establish fellowships to support our best and brightest trainees *All numbers as of December 31, 2017.
34
NORTHWESTERN M EDICIN E • WINTER 2018
Northwestern has helped
With Dr. Betty Hahneman’s
I am a proud faculty member
generous support and
and alumnus, and I’m happy
that of so many other scholarship donors, my
to support this fundraising
fellow students and I can take out less loans
effort, both as a donor and advocate,
and, thus, have more options after graduation.
because I know that the funds we provide will
Having less debt will make it easier to focus on
support breakthrough medical education and
my passion for service rather than the pursuit
ultimately improve patient care and change
of financial gain. After medical school, I hope
people’s lives for the better.
to work as a clinician while working on health policy, perhaps in research or implementation.
Neil Stone, ’68 MD, ’74, ’75 GME Robert Bonow, MD, Professor of Medicine
I also will continue to advocate for patients and those who cannot even afford to be patients. Robert Tessier, Class of 2021 Betty M. Hahneman, MD, MPH, Scholar
67 new scholarships created during We Will. The Campaign for Northwestern Medicine
795 faculty members made a gift of any amount to Feinberg
153 different funds supported
PROGRESS NOTES
We’d love to hear from you! Please share your recent news, accomplishments and important milestones with us.
jacket and carried our black doctor bag. We also carried red rubber gloves, which had
1980s Richard B. Lanman, ’81 MD, a biotechnology
to be boiled and dried off to be sterile. At night,
entrepreneur, was named to the board of direc-
we went with a police escort.
tors for BIOLASE, Inc., a dental laser company.
Send your updates and high-resolution photos to
[email protected]. We will publish them in an upcoming issue of the magazine.
We went in pairs with a nurse, and each
of us wore our short, white medical school
To this day, I still have my Maxwell
Street Dispensary diploma from the Chicago Maternity Center hanging on the wall of my office. I am still working as an OB-GYN for UCLA Health in Torrance, California.”
1
Boris Lushniak ’83 MD, MPH, was recognized by the American Medical Association (AMA) with a Distinguished Service Award for his contributions to the field of public health. Lushniak played an active role in government
Charles F. Koopmann Jr., ’69 MD, was presented with the Bicentennial Faculty Governance Lifetime Achievement Award at
1950s
the University of Michigan. Now retired from
Ruth Benson, ’55 BSN, writes, “I gradu-
sion of the Department of Otolaryngology and
ated with a BS in Nursing in 1955. I have been living in Fairbanks, Alaska, since 1960 and
the university, Koopman led the pediatric divialso served on the advisory board for intercollegiate athletics.
retired from a position as a contract nurse
1
practitioner in family planning at the Fairbanks Regional Health Center in 1992. Before that, I had been a nurse practitioner in college health
1970s
at the University of Alaska Fairbanks. Most
James (Jim) E. Bourdeau, ’73 PhD, ’74 MD,
of my university work took place at St. Olaf College in Northfield, Minnesota, for the three years before I enrolled at Evanston Hospital in 1952. It all seems extremely remote now!”
received the Albert Nelson Marquis Lifetime Achievement Award from Marquis Who’s Who. Following a career that encompassed basic research in renal physiology, clinical practice in nephrology and kidney transplantation, and service on the American Board of Internal
1960s Michael L. Friedman, ’67 MD, shared memories from the Chicago Maternity Center after reading about a novel set there written by
Medicine’s Test-Writing Committee in the subspecialty of nephrology, Bourdeau has retired in Satellite Beach, Florida, while spending as much time as he can find in Quebec City, Canada.
“TO THIS DAY, I STILL HAVE MY MAXWELL STREET DISPENSARY DIPLOMA FROM THE CHICAGO MATERNITY CENTER HANGING ON THE WALL OF MY OFFICE.” -MICHAEL L. FRIEDMAN, ’67 MD
service for nearly 30 years, having served as U.S. Surgeon General (Acting) from July 2013 to
David Kerns, ’68 MD. Friedman writes, “We
David Green, MD, ’74 PhD, professor emeritus
December 2014. He was also Deputy Surgeon
spent two weeks going into the West Side
of Medicine in the Division of Hematology and
General from 2010 to 2013 and from 2014 to 2015, as well as assistant commissioner for
neighborhoods of Chicago to deliver babies
Oncology at Feinberg, was recently selected to
under the most primitive conditions — often
receive the “Walk in Our Shoes” Award from
counterterrorism policy for the U.S. Food and
without any electric lights. I can remember
the Bleeding Disorders Alliance of Illinois.
Drug Administration from 2004 to 2010. AMA
it as though it was yesterday. MAGA ZIN E . N M .ORG
35
ALUMNI
Progress Notes
3
2
4
“THIS PIVOT AND SWING DANCE BETWEEN responses, including his role commanding the only U. S. Government hospital in Liberia CAPILLARY CELL treating Ebola patients during the Ebola crisis OUTER MEMBRANES in 2015. In January 2017, Lushniak became AND MITOCHONDRIA dean of the University of Maryland School of Public Health. 2 PRODUCES POWERFUL FEEDBACK LOOPS THAT Janet Prokop Pregler, ’88 MD, received for the second time in her career the “Women of INCLUDE INTERSTITIAL the Year” award from the Los Angeles County SPACE MESENCHYMAL Board of Supervisors and The Los Angeles CELLS AND THE END County Commission for Women. Pregler is a nationally recognized educator ORGAN ITSELF.” Chair-Elect Jack Resneck, Jr., MD, recognized
Lushniak for his leadership in several disaster
and advocate in woman’s health. Director of the
Iris Cantor-UCLA Women’s Health Center and a professor of Clinical Medicine at UCLA she is co-editor of the textbook “Women’s Health: Principles and Clinical Practice.” She has developed educational programs on women’s health for the American College of Physicians, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, and
-ROBERT BUCKINGHAM, MD, ’79 GME
Michael H. Goldstein, ’93 MD, MBA, was appointed as chief medical officer for Ocular Therapeutix, a biopharmaceutical company focused on developing therapies for eye diseases and conditions. Raymond “Ramiro” Sanchez, ’94 MD, was presented with the Albert Nelson Marquis Lifetime Achievement Award. He is a trained psychiatrist who is senior vice president of global clinical development at Otsuka Pharmaceutical Development and Commercialization in Princeton, New Jersey. Sheila Gujrathi, ’96 MD, was appointed to the board of directors and named as a strategic advisor for TP Therapeutics, Inc., a privately held, clinical-stage biopharmaceutical
Medicare & Medicaid Services Panel on
company focusing on addressing oncology
Hospital Outpatient Payment. The Preglers
drug resistance.
have three children, one currently a freshman at Northwestern University. They look forward to the upcoming alumni reunion and reuniting with classmates and friends.
2000s
the Department of Health and Human Services
Eugene Lin, ’07 MD, medical director of the
Office on Women’s Health.
Mercy Life Flight Network Mobile Stroke
Her husband Johnathan Pregler, ’88
MD, is a professor of Anesthesiology and
1990s
Unit and director of the annual Mercy Health Stroke Symposium, received a
director of Operative Services at UCLA. He
Malcolm M. Bilimoria, ’91 MD, ’98 GME, a
2017 “20 Under 4” Leadership Recognition
is past-president of the California Society of
surgical oncologist at Northwest Community
Award. The award recognizes individuals in
Anesthesiologists and active nationally with
Hospital in Arlington Heights, Illinois, com-
northwest Ohio and southeast Michigan under
the American Society of Anesthesiologists
pleted a 19,341-foot scale of Mount Kilimanjaro
the age of 40 who have distinguished them-
in October with his patient Ken Brown, a sur-
selves in their career and/or community.
as its representative on the Centers for
vivor of adenocarcinoma of the pancreas.
36
NORTHWESTERN M EDICIN E • WINTER 2018
3, 4
Progress Notes
2010s
Risk Factor data. Students reported exposure
Dance Blocks Aging while Decreasing Pain and
to violence and related stressors including
Fatigue” (July 2017, iUniverse), two years after
fighting, perceptions of safety and other high-
his first book “Hazing Aging.”
Frank A. Clark, ’10 MD, has been appointed
risk behaviors. The study found a much higher
to the Dean’s Council on Advancement for the
self-reported rate of gun carrying and a higher
the mechanics of how capillary cells actually
Virginia Tech Carilion School of Medicine. The
burden of violence exposure among Chicago
support two organ systems, as they go about
council is a committee of volunteers created to
respondents across all study waves. These
their business of sanitizing the interstitial
advance the stature of the medical school by
data predate the recent (2016) surge in Chicago
space and supporting the end organ. They ac-
providing guidance, assistance, advocacy and
shootings and homicides, yet the higher rate
complish this task with a dynamic and complex
He writes, ‘Rejuvenation!’ dives into
philanthropic investment in support of the
of gun carrying in Chicago may reflect easier
outer membrane receptor system that has a
school’s strategic objectives.
access to firearms as well as more intensive
major feedback loop relationship with their
segregation, poverty and hopelessness than
mitochondria. As they increase their permea-
Samaa Kemal, ’17 MD, ’17 MPH, presented her
what was experienced by youth in other cities.
bility, mitochondria shift combustion to energy
culminating experience research paper at the
The paper will be published in an upcoming
to support active transport of immune arsenal
2017 22nd Annual Injury Free Coalition for
issue of Injury Epidemiology.
into the interstitial space. When outer mem-
Kids conference on December 1-3. Kemal’s
branes decrease immune arsenal trafficking,
presentation was awarded best research paper
they cause mitochondria to shift combustion to
distinction.
nitric oxide, which chain reacts a causes a com-
Kemal’s study evaluated trends and risk
factors over time for self-reported gun car-
GME
pletely different set of capillary cell operations.
This pivot and swing dance between cap-
Robert Buckingham, MD, ’79 GME, published
illary cell outer membranes and mitochondria
school students in Chicago, New York City and
his second book on chronic inflammation
produces powerful feedback loops that include
Los Angeles using 2007–2013 Youth Behavioral
called “Rejuvenation!: How the Capillary-Cell
interstitial space mesenchymal cells and the
rying among freshman and sophomore public
ALUMNI WEEKEND 2018 • APRIL 27 & 28
Not just for reunion classes! • Earn up to 6.25 CME Credits at forums • Attend our Women in Medicine Tea at the Drake Hotel • Enjoy a buffet from Gibson’s Steakhouse at our
For more information, please visit our website at www.feinberg.northwestern.edu/alumni/ alumni-weekend or call 312-503-8012.
Celebrate in Chicago All Alumni Reception & Dinner • Participate in our Young Alumni Social
MAGA ZIN E . N M .ORG
37
ALUMNI
Progress Notes
5
6
8
7
in Puerto Rico to provide medical expertise
end organ itself. Chronic inflammation within
She is the dean for clinical research at the
interstitial space disrupts these feedback loops
University of Chicago Medicine and Biological
and medication just two weeks after Hurricane
by cannibalizing the capillary cell from the
Sciences and a professor of Pediatrics and
Maria ravaged the island in September.
inside out by employing a combination of
section chief of Hematology/Oncology in the
Mizuno’s private practice, OMNI Healthcare,
vascular inflammatory free radicals and the
Department of Pediatrics.
body’s own immune arsenal.” Henry J. Przybylo, MD, ’85 GME, published “Counting Backwards: A Doctor’s Notes on Anesthesia,” a book that chronicles his career and thoughts about the specialty during his long career at Northwestern. Przybylo is an associate professor of Anesthesiology at Feinberg and a pediatric anesthesiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago. Julian Schink, MD, ’86 GME, joined Cancer Treatment Centers of America (CTCA) as chief of Gynecologic Oncology. He will also serve as medical director of Gynecologic Oncology and Medical Oncology at the CTCA at Midwestern Regional Medical Center in Zion, Illinois. Schink brings more than 30 years of oncology experience to the organization, specializing in surgery, chemotherapy, hormone therapy
serves a large Puerto Rican patient population
ERIC MIZUNO, MD, ’92 GME, HITCHED A RIDE ON A PRIVATE PLANE AND LANDED AT A CLOSED AIRPORT IN PUERTO RICO TO PROVIDE MEDICAL EXPERTISE AND MEDICATION JUST TWO WEEKS AFTER HURRICANE MARIA RAVAGED THE ISLAND IN SEPTEMBER.
and targeted therapy treatments for patients
E. Dale Abel, MD, PhD, ’92 GME, was elected
with gynecologic cancers. Schink will oversee
president-elect of the Endocrine Society. His
the national Gynecologic Oncology Program at
term will commence March 20, 2018, and his
CTCA, serving patients in the treatment of
presidential term will begin on March 20, 2019,
cervical, ovarian, uterine, and vaginal and
for one year. Abel is the Francois M. Abboud
vulvar cancers, as well as gestational tropho-
Chair in Internal Medicine at the University of
blastic diseases.
Iowa Carver College of Medicine.
5
6
in Chicago’s Humboldt Park, so he immediately felt called to respond to the overwhelming needs of the island’s residents. Mizuno is also a clinical assistant professor of Medicine in the Division of General Internal Medicine and Geriatrics at Feinberg.
7
Richard Lawrence Makowiec, MD, ’99 GME, joined Franciscan Physician Network Orthopedic Specialists, which is based in Indianapolis. Laure DeMattia, MD, ’03 GME, joined Norman Regional Health System, which is based in Oklahoma. DeMattia specializes in medical weight loss.
8
Melina Kibbe, MD, ’03 GME, received the prestigious Dr. Rodman L. Sheen and Thomas G. Sheen Award at the annual meeting of the New Jersey Chapter of the American College of Surgeons, held December 2, 2017, in Iselin, New Jersey. The Sheen Award is presented each year to honor individuals who have made outstanding contributions to the medical profession. Kibbe inspired attendees with her presentation of “When Mice are Men: Sex Bias in Surgical Research” during the meeting.
Susan Cohn, MD, ’87 GME, was named to the
Eric Mizuno, MD, ’92 GME, hitched a ride on
board of directors for St. Baldrick’s Foundation.
a private plane and landed at a closed airport
National Academy of Medicine on October 14,
38
NORTHWESTERN M EDICIN E • WINTER 2018
Kibbe was elected as a member of the
Progress Notes
In Memoriam
Maurice K. Roskelley, ’56 MD Salt Lake City, Utah
Northwestern Medicine expresses its condolences to the families and friends of the following alumni (listed in order of their graduation year) and faculty who have recently passed away. All dates are in 2017.
SEPTEMBER 23
ALUMNI Sam A. Marascalco, ’43 DDS Tucson, Arizona FEBRUARY 1
Gerald O. McDonald, ’47 MD, ’48 GME Great Falls, Virginia OCTOBER 12
Robert W. Denton, ’47 MD Bishop, California OCTOBER 28
George R. Clutts, ’48 MD Greensboro, North Carolina SEPTEMBER 13
Mary M. Stoskopf, ’49 MS Overland Park, Kansas NOVEMBER 4
Charles H. Boggs Jr., ’50 MD, ’56 GME Roanoke, Virginia OCTOBER 8
E. Eliot Benezra, ’50 MD Oak Brook, Illinois OCTOBER 2
Charles Boggs Jr. ’50 MD, ’56 GME Roanoke, Virginia OCTOBER 8
Margaret P. Steinam, ’52 MD, ’54, ’56 GME Mequon, Wisconsin NOVEMBER 20
David Paul Cooney, ’54 MD Stanford, California SEPTEMBER 27
William R. Vogler, Jr., ’54 MD Decatur, Georgia
9
10
Dale R. Hines, ’57 MD Dayton, Ohio SEPTEMBER 19
Stanley M. Englander, ’59 MD Rockland, Maine OCTOBER 19
Pacita Manalo Estrella, ’63 MD Reno, Nevada OCTOBER 20
Emmett J. Sharkey, ’65 MD San Diego, California OCTOBER 8
Edward M. Katz, MD, ’65, ’66 GME Menlo Park, California SEPTEMBER 24
Norman K. Wood, ’66 MSD, ’68 PhD Perth, Ontario, Canada OCTOBER 21
Winston D. Crabb, ’67 MD Rio Rancho, New Mexico SEPTEMBER 30
Michael W. Witwer, ’67 MD, ’73 GME Santa Rosa, California SEPTEMBER 25
Robert Scott Zeiders, MD, ’67 MD Savoy, Illinois
2017. Election to the Academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service. 9, 10 Richard Zorowitz, MD, ’09 GME, was named a 2017 Top Doctor in Washington, D.C. He is a physical medicine and rehabilitation physician with the MedStar National Rehabilitation Network. Hala Yamout, MD, ’13 GME, received the 2017 St. Louis Veteran Affairs (VA) Medical Staff Recognition Award. Yamout is a staff physician in the Department of Nephrology at the St. Louis VA.
NOVEMBER 24
Robert G. Cook, MD, ’78 GME Kenosha, Wisconsin SEPTEMBER 23
Susan M. Haack, MD, ’88 GME Anthem, Arizona DECEMBER 30
Thomas J. Mango, ’89 MD Granger, Indiana OCTOBER 3
DPT Patrick Blair, ’90 BSPT, joined Olympic Physical Therapy as a physical therapist. Blair has 27 years of outpatient orthopedic experience working in the south suburbs of Chicago. His area of clinical interest is hand and upper extremity rehabilitation.
Danielle Alana Peress, MD, ’16 GME New York, New York NOVEMBER 26
DECEMBER 2
MAGA ZIN E . N M .ORG
39
ALUMNI
Perspective WRIT TEN BY
William Weber, ’17 MD, ’17 MPH
MARK ONE OR MORE BOXES
A young alumnus debates the utility of clustering patients into demographic categories.
The category of Pacific Islander includes
certain groups have unequal outcomes. As
The 80-year-old woman came to my ER with
lower abdominal pain. I started thinking
less than 2 million people globally, while the
through my differential: diverticulitis, urinary
category Asian includes 4.5 billion and would
these patterns and seek to eliminate them.
tract infection, maybe appendicitis. Her labs
lump together the experiences of Chinese
came back showing nothing. During a second
and Indian Americans. If someone orders
mation daily to risk stratify patients while
round of questions, she mentioned a new
Asian food, they would be surprised if they
taking their history. There are many deter-
boyfriend at the nursing home. It turned
got dosas and tandoori chicken, which means
minants of health, and understanding the
physicians, we must both be cognizant of As a physician, I use demographic infor-
out that my frisky octogenarian had a case
that Grubhub somehow outpaces many
risk ratios associated with certain population
of chlamydia.
electronic health records at differentiating
groups helps to steer my workups. That being
people groups. Boxes reduce individuals to
said, individuals are unique. I anchored on
often ill-fitting categories that may not
my 80-year-old's likely diagnoses differently
We categorize people in medicine all the
time. Young, old, black, white, female, male, THESE BOXES AND I HAVE A bipolar relationship. I find boxes complicated because they are frustratingly inexact and reductionist but still point out significant societal trends to address.
this, that. Every demo-
reflect their experience.
because we less frequently associate sexually
graphic survey has a
transmitted infections with the elderly. It is
slew of boxes that tries
of inequality in populations, where large
to compartmentalize
sample sizes average out disparate individual
come from anywhere on the bell curve.
us as people. These
experiences. The ignoble groupings have a
boxes and I have a
brutal simplicity, yet still manage to reveal
parities between groups helps me advocate to
Boxes perform better in revealing trends
crucial to remember that our patients may At a population level, knowledge of dis-
bipolar relationship.
large disparities. What the roughhewn
eliminate those differences. I chose to pursue
I find boxes compli-
categories lack in specificity, they
a master of public health degree during
cated because they are
make up for in unearthing
medical school so that I could
frustratingly inexact and reductionist but still
areas to research: White
point out significant societal trends to address.
people are x times
parate epidemiol-
more likely to have
ogy of disease and
The analytical side of me contests
better understand the dis-
the boxes. What should be an orderly and
health insurance
address it through
intuitive grouping generally ends up a messy
than black people.
policy, especially
hodgepodge of categories forming an impossi-
The statistics
among victims of gun
ble Venn diagram.
shed light on
violence and the res-
Consider the U.S. government’s five
aspects of
identially displaced.
minimum categories for collecting data on
American life
My hope is that
race: American Indian or Alaska native, Asian,
in which
through advocacy
black or African American, Native Hawaiian or other Pacific Islander, and white — the race
and hard work, the demographic boxes
boxes are a mix of skin tone, people group and
that our patients check
geographic region. What about my Russian
will cease being risk
friends? Do they pick Asian to match geogra-
factors for disease.
phy or white to match skin color? Or friends from Algeria or Pakistan, both of whom the government unceremoniously dumps into the white category. 40
NORTHWESTERN M EDICIN E • WINTER 2018
ILLUSTR ATION BY Jérôme Mireault
Northwestern Medicine Through the Years
1583–present Artifacts from Special Collections RARE BOOKS
F
einberg’s Galter Health Sciences Library and Learning Center houses thousands of rare, unique and historical materials within its Special Collections Department. The collections include medical and dental works from European and American sources, spanning the 15th through the 20th centuries, with strengths in anatomy, pathology, obstetrics and gynecology, and urology, among other areas. The department also
RE AD MORE ABOUT TH ES E R ARE BOOKS IN OU R HISTORY B LOG AT MAGA ZIN E . N M .ORG
WARD ROUNDS
houses medical and dental artifacts, manuscripts, institutional and personal archives and more. Pictured above: The top nine images posted to the Special Collections’ Instagram account (galter_special_collections) in 2017. Among these pages are a municipal report on all the deaths reported in London in the year 1665, including “French Pox” and “Kings Evill” (third row, third column), and a 17th century medical book that attempts to classify deformities and congenital abnormalities, including those that afflict fantastical creatures (third row, second column).
Photos courtesy of Katie Lattal
MAGA ZIN E . N M .ORG
41
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